ODA Journal: July/August 2020

July/August 2020 | Vol. 111, No. 4

University of Oklahoma College of Dentistry Class of 2020

www.okda.org

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Contents

ADVERTISERS Thank you to these businesses who advertise in the ODA Journal

July/August 2020 | Vol. 111, No. 4

EDITORIAL

Inside Front Cover Valliance Bank

0 6 Guest Editorial: Dr. Paul Mullasseril, ODA President

ASSOCIATION

Inside Back Cover Dr.First

04 Calendar of Events 0 5 Welcome New ODA Members 08 ODA Member Benefit Corner

Back Cover Delta Dental of Oklahoma 3000IG Authentic Dental Labortorie, Inc. Edmonds Dental Prosthetics,Inc. Endodontic Associates iCoreRX Lewis Health Profession Services MedPro Group ODASupplySource TDSC THE OKLAHOMA DENTAL ASSOCIATION JOURNAL (ISSN 0164-9442) is the official publication of the Oklahoma Dental Association and is published bimonthly by the Oklahoma Dental Association, 317 NE 13th Street, Oklahoma City, OK 73104, Phone: (405) 848-8873; (800) 876-8890.

Fax: (405) 848-8875. Email: information@ okda.org. Annual subscription rate of $39 for ODA members is included in their annual membership dues.

POSTMASTER: Send address changes to OKLAHOMA DENTAL ASSOCIATION JOURNAL, 317 NE 13th Street, Oklahoma City, OK 73104.

Periodical postage paid at Oklahoma City, OK and additional mailing offices.

Subscriptions: Rates for non-members are $56. Single copy rate is $18, payable in advance.

09 ODA Marketing Coach

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Dr. Raymond Cohlmia

ODA Saddoris Award Winner

Copyright © 2019 Oklahoma Dental Association.

10 ODA Rewards Partners 11 ODA Partners Column 1 4 Dr. Raymond Cohlmia,ODA Saddoris Award Winner 1 6 2020 ODA Award Winners 50 Final Thoughts: Words of Wisdom

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New Dentist Corner: A Non-traditional Path to Dentistry

LEGISLATIVE LOOP 1 8 2020 Legislative Session Summary 1 9 2020 OKCapitol Club & DENPAC Grand Level Members

SPOTLIGHT 2 2 Tribute to ODA 50-Year Members

FEATURES Cover Photo: 2020 OUCOD Graduates practicing social distancing and wearing face masks as they pose for a group photo. Some individuals were unable to make the photo.

There were a total of 65 graduates. Welcome new members!

2 6 Survey of Oklahoma Dental Professionals on Detecting/Reporting Child Abuse and Neglect 30 Antibiotic Prescribing Trends Among Oklahoma Dentists 31 Practicality and Efficacy of Periodontal Trays as an Adjunctive Therapy 32 Atraumatic Extractions 34 How Do We Respond to the "New Normal"?

36 Collect What You Produce (Part 5 of 10) 38 Hygiene Hotspot 39 New Dentist Corner 4 0 Congrats to OUCOD Class of 2020

Reprints: of the Journal are available by contacting the ODA at (405) 848-8873, (800) 876-8890, editor@okda.org.

Opinions and statements expressed in the OKLAHOMA DENTAL ASSOCIATION JOURNAL are those of the author and are not necessarily those of the Oklahoma Dental Association. Neither the Editors nor the Oklahoma Dental Association are in any way responsible for the articles or views published in the OKLAHOMA DENTAL ASSOCIATION JOURNAL.

Oklahoma Dental Association

4 1 2020 ASDA Award Winners 4 2 Why Every Prescription Should Be an Electronic Prescription

Is Your Information Correct?

Help the ODA keep you informed about legislative actions, CE opportunities, events and other important member-only news.

Contact Kylie Ethridge, ODA Membership Director, at kethridge@okda.org or 800.876.8890 to provide the ODA with all of your current contact information.

4 4 What Dental Professionals Can Do to Curb Vaping Among Teens 4 6 Oklahoma Scores a "D" on Its Oral Health Report Card

CLASSIFIEDS 4 9 ODA Classified Listings

www.okda.org

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ODA JOURNAL STAFF EDITOR Mary Hamburg, DDS, MS ASSOCIATE EDITOR Frank J. Miranda, DDS EDITORIAL BOARD MEMBERS M. Edmund Braly, DDS Daryn Lu, DDS Phoebe Vaughan, DDS EXECUTIVE DIRECTOR F. Lynn Means DIRECTOR OF COMMUNICATIONS & EDUCATION Stacy Yates OFFICERS 2020-2021 PRESIDENT Paul Mullasseril, DDS president@okda.org PRESIDENT-ELECT Chris Fagan, DDS presidentelect@okda.org VICE PRESIDENT Robert Herman, DDS vicepresident@okda.org SECRETARY/TREASURER Mike Gliddon, DDS treasurer@okda.org SPEAKER OF THE HOUSE Doug Auld, DDS speaker@okda.org IMMEDIATE PAST PRESIDENT Dan Wilguess, DDS pastpresident@okda.org ADMINISTRATIVE STAFF EXECUTIVE DIRECTOR F. Lynn Means DIRECTOR OF GOVERNANCE & FINANCE Shelly Frantz DIRECTOR OF COMMUNICATIONS & EDUCATION Stacy Yates DIRECTOR OF MEMBERSHIP Kylie Faherty PROGRAMS & OPERATIONS MANAGER Makenzie Dean SPECIAL PROJECTS MANAGER Abby Sholar MEMBERSHIP SERVICES MANAGER Madison Bolton

Stay connected with the ODA!

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journal | July/August 2020

CALENDAR OF EVENTS

N NEW ODA MEMB NEW ODA NEW ODA NE NEW NEW ODA MEMB NEW N NEW ODA M NEW OD NEW ODA MEMB NEW O NEW O

Visit the ODA’s online calendar at OKDA.ORG/CALENDAR for all upcoming meetings and events.

July 2-3 ODA Closed July 13 Investment Committee Meeting Zoom 5:30 p.m.

July 31 Veteran's Dental Day Planning Meeting Zoom 8:00 a.m.

Governmental Affairs Zoom 9:00 a.m.

ODA Board of Trustees Meeting Zoom 1:30 p.m.

August 1 ODA Zoo Day OKC Zoo 8:00 a.m.

August 28 Council on Dental Care Meeting ODA Building 1:00 p.m.

September 7 ODA Closed

NEW ODA MEMBERS NEW ODA MEMBERS BERS NEW ODA MEMBERS Welcome, New Members MEMBERS NEW ODA MEMBERS New Members Joined April 29 - June 4 A MEMBERS NEW ODA MEMBERS EW ODA MEMBERS NEW ODA MEMBERS W ODA MEMBERS NEW ODA MEMBERS Oklahoma County Elassal BERS NEW ODA MEMBERS Phillip Tulsa County Londel Fields W ODA MEMBERS NEW ODA MEMBERS Oklahoma County Damon Johnson Kirkpatrick Central District NEW ODA MEMBERS NEW ODADeNae MEMBERS MEMBERS NEW ODA MEMBERSBrittany Macleod Tulsa County DA MEMBERS NEW ODA MEMBERS BERS NEW ODA MEMBERS ODA MEMBERS NEW ODA MEMBERS ODA MEMBERS NEW ODA MEMBERS Please join the ODA in welcoming our new members into Oklahoma’s Community of Organized Dentistry

www.okda.org

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ODA EDITORIAL

Paul Mullasseril, DDS 2020 -2021 ODA President

After a tumultuous few months, the school year has come to an end for our fourth-year dental students. I had the opportunity to witness an entire group of young professionals endure the unexpected stress resulting from uncertainties created by the COVID-19 crisis. Terrible times build great leaders, and I am sure the die has been cast for many in this group to be exceptional leaders in our profession.

What they have lost in not having a graduation ceremony or a senior night with awards presentations, they have gained in terms of crisis management, stress control and life experience. Dentistry is among the most highly rated professions in the country. It is up to these young professionals to take the baton and continue the race and keep our profession at the top. A word of advice I give most graduating classes is that the trust their patients have in them is sacred. In order to maintain that trust I advise them to “Do as much as you can for your patient, and do as little as you can to your patient.”

I am proud of the way dentists in our state have responded to this crisis. We have not all agreed on every issue revolving around the crisis, but we have come together and stood together as a profession. The American Dental Association’s leadership has guided us in the difficult choices we have had to make. Most, if not all, offices are open at this time and we continue to exemplify what it takes to perform effective infection control, treat our patients and care for our employees. As I mentioned in an earlier communication to you: in the words of Mark Twain, “Always do right. It will gratify some and astonish the rest.”

American innovation has been in the spotlight over the past few months. New and improved products for use in dental clinics have sprung up like mushrooms on a well-manicured lawn.

I just spoke to a dentist-entrepreneur who wanted the dental school to try a product that would sanitize the dental office for ten days via a slow-release disinfectant.

Various new contraptions that look like gadgets out of a Star Wars movie have hit

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journal | July/August 2020

the market. Among the various lessons learned during this crisis is that we are leaders in innovation and we can stand up to any challenge, but we need to bring manufacturing back to this country. We need gowns made in the USA! As I look forward to the coming months, I wish all of you success; I wish our new graduates happiness in their lives; and I wish our extended families in the dental community peace. Let us pray that the coming months also bring peace and healing to our nation. Just as you have embraced me, a brown man, embrace someone who does not look like you in the next couple of months. Growing up, we were always told to “be good and do well.”

I challenge you to “do good and be well.”

" Just as you have embraced me, a brown man, embrace someone who does not look like you in the next couple of months... I challenge you to do good and be well."

With storm season approaching, Oklahomans face the risk of devastating disasters.

DON’T GET CAUGHT IN THE RAIN

Make a tax-deductible contribution to the RDGP The Oklahoma Dental Relief and Disaster Grant Program (RDGP) is a charitable trust established to provide aid to dental professionals affected by natural disasters,physical disability, chemical dependence, or other hindering conditions.

The RDGP is reliant solely on contributions from individuals like you. Help Prepare & Provide for those in need. You never know when it could be you.

Contact the ODA at 800.876.8890

www.okda.org

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ODA MEMBER BENEFIT CORNER Why is a membership with the ODA/ADA so valuable?

The ODA/ADA supports all members at the national, state and local levels. From helping you manage your practice more efficiently and advocating on your behalf to offering you tools and resources that help you find the answers for which you’re looking, we’re there every step of the way.

Laurel Road Student Loan Refinance Program By: Madison Bolton, ODA Membership Manager According to the American Dental Education Association, 39% of indebted dental school graduates in the Class of 2019 reported student loan debt of more than $300,000.

As a member benefit, the American Dental Association (ADA) exclusively endorses the Laurel Road Student Loan Refinance program. This program provides unmatched opportunities for ADA members to refinance existing federal and private undergraduate and graduate school loans at a 0.25% lower rate than Laurel Road’s already low rates.

Dentists can refinance dental school loans during residency or wait until they are employed full-time.

Refinancing student loans may add up to significant savings. For example, if you refinance multiple loans into one loan with a lower rate and keep the loan term the same, you will accrue less interest over the life of the loan, saving you money every month and throughout the loan.

According to Laurel Road, there is no maximum loan size, just a minimum loan size of $5,000. And in the event of the borrower’s death or permanent disability, they will be granted loan forgiveness.

Laurel Road began originating student loans in 2013 and has since helped thousands of professionals with undergraduate and postgraduate degrees consolidate and refinance more than $4 billion in federal and private school loans.

Laurel Road also offers a suite of online graduate school loan products, personal loans, and mortgages that help simplify lending through technology and personalized service.

Discover your personalized rate options online today by visiting LaurelRoad.com/ ADA. It only takes a few minutes and leaves no impact on your credit score!

You could save thousands on your student loans 1

ADA members get a 0.25% rate discount2 when refinancing. Check your rates in less than 5 minutes3 at LaurelRoad.com/ADA.

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1. Savings vary based on rate and term of your existing and refinanced loan(s). Refinancing to a longer term may lower your monthly payments, but may also increase the total interest paid over the life of the loan. Refinancing to a shorter term may increase your monthly payments, but may lower the total interest paid over the life of the loan. Review your loan documentation for total cost of your refinanced loan.

2. The 0.25% American Dental Association (ADA) member rate discount is offered for applications from ADA members in good standing. The rate discount will end if ADA notifies Laurel Road that borrower is no longer in good standing. Offer cannot be combined with other offers, including the Referral Program.

3. Checking your rate with Laurel Road only requires a soft credit pull, which will not affect your credit score. To proceed with an application, a hard credit pull will be required, which may affect your credit score.

Laurel Road is a brand of KeyBank National Association offering online lending products in all 50 U.S. states, Washington, D.C., and Puerto Rico. All loans are provided by KeyBank National Association, a nationally chartered bank. ©2019 KeyCorp® All Rights Reserved. Laurel Road is a federally registered service mark of KeyCorp. journal | July/August 2020 20190708_ADASLRAD_7.5x5 Member

ODA MARKETING COACH

Managing Marketing

Inquiries from Prospective Patients Every practice loses prospective patients through unsatisfactory management of incoming calls. While it takes many forms, it usually happens when the caller hangs up because the phone wasn’t answered fast enough, when the caller hangs up instead of waiting on hold, or when the caller doesn’t feel a personal connection with the team member answering his/her questions about the practice.

Practices that have trained staff to effectively manage telephone communications and build rapport with patients have an easier time retaining them. On the other hand, practices that haven’t invested in properly training staff members on the best ways to connect with prospective patients can lose the opportunity to convert those callers into active patients.

Any team member who answers the phone should be able to interest callers in coming into the practice.

Calculate your practice’s rate of lost calls from prospective patients by having the administrative staff track the number of new patient calls received each week for one month. Compare that number to the number of new callers scheduled for an office visit. Some practices lose as many as 30-50% of the initial contacts.

A loss of more than 20% could indicate that your staff and your practice would benefit from some additional training on managing calls.

It’s not uncommon for dentists managing practices with high rates of lost calls from prospective patients to infer that marketing isn’t effective because they aren’t seeing strong results. While marketing drives the prospective patient to call your practice, it’s up to you to make sure your team has the training and communication skills needed to make the caller want to come in for treatment.

You can assess your team’s communication skills by role-playing some of the most common telephone calls you receive from prospective patients. Another option is to record actual calls and listen to them during a team meeting; this approach allows you to coach staff on what cues should receive which response and will help them interact with first-time callers more effectively. Many jurisdictions have laws requiring permission from employees and/or callers before they can be recorded.

Make sure you investigate whether your jurisdiction has any such laws and always comply scrupulously with them.

Schedule your team for a course, program or webinar on effective communication skills if they haven’t had that type of training recently. Courses may be available through your state or local dental association, other professional associations and other sources.

Technology can also help your practice connect with prospective patients who contact the practice from a mobile device.

Training your staff in effective communication is a worthwhile investment that pays other dividends and can convert prospective patients to active patient status.

This lets them know you’re aware that the call was not answered and that you care enough to follow up. Call them as soon as possible to find out how your practice can be of service. Calls that originate from landlines cannot be messaged this way.

Include your entire staff in communications training; patients often ask questions of any staff member and this could also lead to increased treatment acceptance rates.

LOOKING FOR CE? The ODA and ADA have recorded webinars on a wide range of topics.

Consider sending “missed call” text messages to any individual whose call was missed.

Copyright © 2020 American Dental Association.

All rights reserved. Reprinted by permission.

For additional resources on how to grow your practice, visit the ADA’s Center for Professional Success at ada.org/success

Future issues of the ODA Journal will include individual articles from this module, but you can see the module in its entirety at http://success.ada.org/en/ practice-management/marketing.

ODA WEBINARS: bit.ly/2zwv2eP ADA WEBINARS: bit.ly/2XZK71J *The Oklahoma Board of Dentistry allows for 50% of the total requirement of CE hours to be obtained from self-instruction programs, like recorded webinars. Live webinars are considered the same as in-person courses. www.okda.org

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These are endorsed companies of the ODA that save members money while keeping dues lower by providing royalties to the Association.

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ODA PARTNERS COLUMN The ODA endorses companies that have been researched and proven to offer products and services that provide real savings. By being an ODA member, you’re automatically eligible for these savings. Learn about all of the Partners at www.okda.org/rewards-partners.

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JAMES A. SADDORIS LIFETIME OF LEADERSHIP AWARD Dr. Raymond Cohlmia has dedicated his career to the promotion and progression of the dental profession and organized dentistry. Since his graduation from dental school in 1988, Cohlmia has been vital to the advancement of dentistry in Oklahoma. He has been the Dean of the University of Oklahoma College of Dentistry since 2015. He is a past president of the Oklahoma Dental Association, has served as a delegate to the American Dental Association and is the immediate past Trustee of District XII for the American Dental Association.

Prior to serving as Dean, Cohlmia created an entirely new practice model for student/patient care as Chair of Comprehensive Care, and fully integrated that practice model while serving as Assistant Dean for Patient Care. He was in private practice for twenty-seven years practicing with his father, Dr. Ray Cohlmia, and brother, Dr. Matt Cohlmia, while teaching part time at the College in several departments.

Cohlmia has been accoladed many times throughout the years for his involvement and leadership within the ODA. He is the only dentist to have received “Outstanding Dentist of the Year” (now called, “Distinguished Dental Service” Award) twice. In the past 28 years, he has received many honors and awards from the ODA and other organizations.

Cohlmia has been a vital player in progressing the dental profession and is a knowledgeable and effective leader to those who have had the honor of serving with him. He served as ODA president in 2001-2002, and as Editor of the ODA Journal for twelve terms. He has served in nearly every capacity at the local and state level, including all local and state presidencies. He is also past president of the College of Dentistry Alumni Association. Nationally, he has served on and chaired numerous American Dental Association committees and councils. He served as chair of the Council on Membership and the Committee on the New Dentist. He served on the Council on Dental Benefits Programs, the Council on Annual Sessions and International Programs and the American Dental Political Actions Committee Board. He was a member of and author for the Clinical Practice and Management Panel for the ADA Future of Dentistry Project and has chaired four reference committees for the ADA. He has been a speaker and trainer for CAD/CAM Dentistry, and continues to provide many presentations on organizational and motivational management.

Cohlmia and his wife, Sherry, have raised three sons, Derek, Brandon and Joshua. Dr. Derek Cohlmia practices dentistry in Oklahoma City, Dr. Brandon Cohlmia practices dentistry in Bethany and Joshua is currently a student at the Univeristy of Oklahoma. Dr. Raymond Cohlmia has fostered a respect and passion for dentistry throughout the United States. The Oklahoma Dental Association is honored to have been led by a man of such integrity, humility and initiative.

Young Dentist of the Year PAST ODA 1992: 2004: Distinguished Dental Service 14 journal | July/August 2020 2005: Benjamin Franklin Scroll AWARDS

2012: President’s Leadership 2014: Distinguished Dental Service 2016: Robert K Wynne for Dental Education & Public Information

I am truly blessed to not only be Raymond’s colleague, but also his brother. Growing up with him, you could tell that he was going to be a leader in whatever field that he chose. Both of us followed our father’s footsteps to become dentists. Practicing with my brother for 23 years, I was able to witness the caring passion that he gave to his patients, as well as the love and respect that he had for the profession. He put all his energy and more into his terms as president of both ODA and OCDS, delegate to the ODA and ADA, and finally ADA 12th District Trustee. All this, plus the many councils and committees of the Tripartite that he served and chaired unselfishly. And now that energy and desire is focused on our future colleagues of our profession, by being Dean of the University of Oklahoma College of Dentistry. I cannot think of anyone that is more deserving of the James A. Saddoris Lifetime of Leadership Award than Raymond. Congratulations, brother!

- Dr. Matthew Cohlmia, Oklahoma Dental Association President 2014-2015

Raymond has always been a hard worker. When I was ADA president, I put a lot on his plate and he never failed to come through. This honor is well deserved.

Congratulations.

- Dr. Gary Roberts, American Dental Association President, 2016-2017 Dr. Cohlmia has been a beacon of leadership in dentistry in the state of Oklahoma for many, many years. His example of leadership, selfless service, and forward thinking has created a bold legacy for dentistry in Oklahoma. From his years of service at the local, state, and national level, Dr. Cohlmia has been a model leader that inspires, challenges, and improves the level of advocacy in the dental profession. As a University of Oklahoma College of Dentistry alumnus, I could not be more proud of how Dean Cohlmia continues to lead, innovate, and inspire our next generation of dentists. As a past president of the Oklahoma Dental Association, I gleaned so much knowledge on how to handle the many issues that arise from Dr. Cohlmia. He taught me to listen, process, and act with fairness and compassion.

His legacy has and continues to be the benchmark by which our future leaders will judge their own selves. My thanks goes to Raymond for being a mentor for 20 years, but more importantly, a friend who I could trust and rely on to speak truth in all situations.

- Dr. Daniel Wilguess, Oklahoma Dental Association President 2019-2020 In addition to his work as an experienced clinician and educator, Dr. Raymond Cohlmia has been a dedicated leader at the ADA. He currently serves as the Chair of the Science and Research Institute of the ADA and served as a Trustee for four years from the 12th District. I’ve come to know him as a trusted colleague, valued contributor, and good-natured friend. His smile is contagious as is his enthusiasm for life (especially for ice cream!) and for his profession. Dr. Cohlmia’s unwavering commitment to service exemplifies what it means to be a leader in the dental profession, and he is well-deserving of ODA’s highest honor.

- Dr. Kathy O’Loughlin, American Dental Association Executive Director The words that come to my mind when I think of Dr. Raymond Cohlmia are passion, enthusiasm and boundless energy. Whether it is dentistry, the matters at the College of Dentistry, or building cars, he does it with the kind of passion I have not witnessed, and he fits in 48 hours every day (I am not sure how). Another thing I admire about him is his love for his family, especially his father and his community. It has been a pleasure knowing him and working for him.

- Dr. Paul Mullasseril, Oklahoma Dental Association President 2020-2021 & Assistant Dean of Clinical and Pre-Clinical Education at the OU College of Dentistry www.okda.org

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TO THE 2020 OKLAHOMA DENTAL ASSOCIATION AWARD WINNERS

DR. TAMARA BERG DAN E. BRANNIN PROFESSIONALISM & ETHICS Dr. Tamara Berg is past president of the Oklahoma Dental Association and the American Association of Women Dentists. She currently serves as a Delegate to the American Dental Association House of Delegates. She received the Smiles for Success Leadership Award in 2011. She has served as Chair of the ODA Governmental Affairs Council and served on the Oklahoma Dental Foundation Board of Trustees, ODA Rewards Committee, DENPAC Board of Directors and the JD Robertson Board of Trustees. Dr. Berg also chaired one of the committees tasked with rewriting the State Dental Act. She is active with the Oklahoma Mission of Mercy and chaired the event in 2011 in Oklahoma City.

DR. MATTHEW COHLMIA ROBERT K. WYNNE FOR DENTAL EDUCATION & PUBLIC INFORMATION Dr. Matthew Cohlmia is past president of the Oklahoma Dental Association and has served on numerous ODA councils and committees. He currently serves on the Councils on Governmental Affairs for both the ODA and American Dental Association. He serves as an Alternate Delegate to the American Dental Association.

He co-chaired the 6th Annual Oklahoma Mission of Mercy in 2016 in Tulsa, OK. He has contributed to dental legislation, as well as public education to advance dentistry across the state and nation.

DR. KEVIN HANEY THOMAS JEFFERSON CITIZENSHIP Dr. Kevin Haney is the Assistant Dean of Student and Academic Administration at the University of Oklahoma College of Dentistry. In that role he oversees the curriculum for both dental and dental hygiene programs as well as the admissions programs.

He also serves as a Professor in the Division of Pediatric Dentistry, providing didactic and clinical instruction to both dental and dental hygiene programs, as well as other health-affiliated programs across the campus. He is active in service to the University and the college’s outreach missions, as well as in many local and national professional organizations. Dr. Haney has been instrumental in developing and serving the pediatric triage and clinic at the Oklahoma Mission of Mercy since its inception in 2010.

16 journal | July/August 2020

DR. CHRIS LESLIE PRESIDENT’S LEADERSHIP Dr. Chris Leslie is a 2010 graduate of the OU College of Dentistry, finishing among the top five in his class. He went on to complete the Advanced Education in General Dentistry Residency Program before settling his practice in his hometown of Stillwater, Oklahoma. It is there that he co-chaired the 2020 Oklahoma Mission of Mercy. As Chair, he was responsible for securing community sponsorships and volunteers, overseeing logistics and acting as spokesperson for the event which brought over $1.4 million in donated dental care to more than 1,200 patients.

REP. RYAN MARTINEZ LEGISLATOR OF THE YEAR Representative Ryan Martinez co-authored and was instrumental in the passage of Senate Bill 948, the ODA’s pre-authorization bill, which was signed into law and went into effect November 1, 2019. It requires insurance companies to stand by their prior authorization and confirmation of coverage determination.

DR. NICOLE NELLIS YOUNG DENTIST OF THE YEAR Dr. Nicole Nellis is a native Tulsan and she decided at the young age of seven to pursue dentistry. After completing her bachelor’s degree at the University of Oklahoma, Dr. Nellis attended dental school at the University of Texas Health Science Center at San Antonio. After graduating at the top of her class, Dr. Nellis returned to complete her AEGD Residency at the OU College of Dentistry. Dr. Nellis is President of the Tulsa County Dental Society and chairs the ODA Council on Membership and Membership Services.

DR. DAVID WONG DISTINGUISHED DENTAL SERVICE Dr. David Wong is a board-certified Periodontist in private practice in Tulsa, Oklahoma. He received his undergraduate education and dental training at the University of Oklahoma. He then went on to complete a three-year residency in periodontics at the University of Missouri-Kansas City. He is a Diplomate of the American Board of Periodontology as well as a Fellow in the International Congress of Oral Implantologists. He is a published author in several peer-reviewed dental journals but has also reached a mainstream audience in media such as Fox News and the Wall Street Journal. Dr. Wong presently resides in Tulsa with his wife and three children where he maintains a full-time private practice.

THESE DISTINGUISHED ODA MEMBERS WILL BE HONORED DURING THE ODA BOARD OF TRUSTEES MEETING ON JULY 31

www.okda.org

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LEGISLATIVE LOOP Legislative Overview & Political Update

Legislature Adjourns

STRANGEST LEGISLATIVE SESSION IN MEMORY

By: Scott Adkins, ODA Contract Lobbyist

The Oklahoma Legislature adjourned the 2020 legislative session sine die (indefinitely) on Friday May 29th, finishing the two-year 57th Oklahoma Legislature. The House of Representatives and Senate both finished their work of passing legislation the previous Friday but did not formally adjourn that day, leaving open the possibility of returning if needed to resolve any unforeseen pandemic or budget issues.

The adjournment officially closes one of the strangest legislative sessions in recent memory. Due to the COVID-19 outbreak the Capitol was closed for seven weeks during March and April, a forced hiatus that resulted in lawmakers considering far fewer measures than normal. During this session, only 176 bills were passed out of both chambers and sent to the Governor’s desk. Gov. Stitt vetoed 12 House bills and six Senate bills this session. Between carryover bills from last year and new bills filed this year, there were more than 4,500 bills and resolutions available to be considered at the beginning of the term.

Unlike the 2019 legislative session, which was marked by civility, teamwork and a high level of decorum between the Legislature and the Executive Branch, 2020 was highlighted by deepening tensions between lawmakers and the Governor, primarily over budget issues and tribal gaming compacts.

While the abbreviated session wreaked havoc on the state budget and most substantive legislative proposals have been shelved until next year, the ODA was successful in securing continued funding for the Oklahoma Dental Student Loan Repayment Program and for the Oklahoma Dental Foundation’s mobile 18 journal | July/August 2020

dental units. One bill vetoed by the Governor that lawmakers did not vote to override was Senate Bill 1046, which would have increased the Supplemental Hospital Offset Payment Program (SHOPP) fee from 2.3 percent to 4 percent. The increase would have provided approximately $134 million annually to help cover the cost of expanding Medicaid.

The measure also included significant protections for our Medicaid and SoonerCare dentists and was supported by the Oklahoma Dental Association.

Robin Roberson, the executive director of the Oklahoma Employment Security Commission (OESC), resigned suddenly under the strain of mounting criticism of the agency that handles unemployment claims. Roberson had only been with the OESC since January, but with a backlog of more than 45,000 approved but unprocessed unemployment claims and little progress being made, the OESC Board moved to make a change. Roberson resigned before being removed. The Board hired Shelley Zumwalt to serve as interim director. Zumwalt has been serving as the chief innovation officer for the Office of Management and Enterprise Services (OMES) since February. The Board also voted to shift its technology and processing system to OMES in an effort to create and maintain a more efficient system for handling claims.

lawmakers will return to next January is uncertain, as well, though most expect the economy to begin recovering in the second half of the year as the state reopens for business.

Though the coming election cycle will certainly be a challenge, your Oklahoma Dental Association will continue our political engagement and count on DENPAC to be active in many of the legislative campaigns around the state.

We encourage all of our membership to seek out their local officials and political candidates and join us in advocating for dentistry, the oral health of our citizens, and the support and protection of our local offices and dental practices. We at the ODA look forward to seeing each of you on the campaign trail.

WHY JOIN DENPAC

Why you join committee denpac DENPAC is theshould political action when paying your dues of your Oklahoma Dental Association.

DENPAC works hard to make political we don’t fundraise... contributions to dentistry-friendly, statewe friendraise! level legislators. $50 of your DENPAC duesis the alsopolitical goes action towards ADPACofto support DENPAC committee your national campaigns.

20% oftothe Oklahoma Dental Association. Currently, DENPAC works hard make political contributionsfunds to dentistry-friendly, stateODA membership 99% of the ODA’s level legislators. $50 of and your advocacy DENPAC duesefforts. also go toward legislative

As the 2020 Legislature comes to a close, lawmakers in both chambers are gearing up for their re-election campaigns. There will certainly be new faces at the Capitol ADPAC to support national campaigns. Currently, 20% of next session, though how many remains the ODA membership funds 99% of the ODA’s legislative and advocacy efforts.TO Most of us don’t want a free ride; JOIN DENPAC to be seen. The turnover should not be as that’s just HOW not our way. We all know it’s a political world Contact Lynnquit, Means at 800-876-8890 extensive as it has been in recent years. and if our 20% should who will carry the weight? or lmeans@okda.org to join What type of economic environment those the DENPAC team TODAY!

We need YOUR help now!

Term limits have found us in a new ball game every two years trying to keep our “dental majority” in both the state

K

CAPITOL CLUB Dr. Jeffrey Ahlert Dr. Errol Allison Dr. Jim Ambrose Dr. Glenn Ashmore Dr. Douglas Auld Dr. Michael Auld Dr. Brandon Beaver Dr. Tamara Berg Dr. David Birdwell Dr. Elizabeth Bohanon Dr. C. Todd Bridges Dr. Matthew Bridges Dr. Jamie Cameron Dr. Patricia Cannon Dr. Wuse Cara Dr. Bobby Carmen

WE DON’T FUNDRAISE. WE FRIENDRAISE! THANK YOU TO THESE 2020 DENPAC CAPITOL CLUB MEMBERS!

Dr. Adam Cohlmia Dr. Matthew Cohlmia Dr. Raymond Cohlmia Dr. Debbie Corwin Dr. James Corwin Dr. Susan Davis Dr. Steven Deaton Dr. Ana Dotson Dr. Brian Drew Dr. Heath Evans Dr. Christopher Fagan Dr. Barry Farmer Dr. John Folks Dr. Stephen Gray Dr. Clark Grilliot Dr. Michael Hansen

Dr. Leslie Hardy Dr. Aaron Harman Dr. Richard Haught Dr. Robert Herman Dr. Jeffrey Hermen Dr. James Hooper Dr. Brad Hoopes Dr. Donald Johnson Dr. Eugenia Johnson Dr. Katherine Johnson Dr. Krista Jones Dr. Mitchell Kramer Dr. Juan Lopez Dr. Alan Mauldin Dr. Stephen Mayer Dr. Glenn Mead

Dr. Robert Miracle Dr. Mohsen Moosavi Dr. Anaita Mullasseril Dr. Paul Mullasseril Dr. Samuel Owens Dr. Karen Reed Dr. Erin Roberts-Svob Dr. Brant Rouse Dr. Miranda Ruleford Dr. Steffan Sigler Dr. Floyd Simon Dr. Lindsay Smith Dr. Brooke Snowden Dr. Braden Stoltenberg Dr. James Strand

Dr. Jim Taylor Dr. Paul Thomas Dr. James Torchia Dr. Charles Tucker Dr. Jonah Vandiver Dr. Christopher Ward Dr. Robert Webb Dr. Mori White Dr. Daniel Wilguess Dr. Ronald Winder Dr. Kendra Yandell

OKCapitol Club is for that “ABC” group of DENPAC members; or those who want to be “ABOVE AND BEYOND CONTRIBUTORS.” OKCapitol Club members truly understand the importance of the ODA’s participation in the political process and want to support candidates who are committed to the state’s oral health and the issues that affect your practice. OKCapitol Club members support those efforts even more by contributing an additional $300 to DENPAC ($470 total) per year. For more information about Capitol Club, contact Lynn Means at 800-876-8890 or lmeans@okda.org.

DENPAC Grand Level DENPAC funds our voice. Without our input, legislators are merely making decisions based on what sounds good, what makes the fewest people angry, or what is easiest for them.

Whether you like it or not, the campaign contributions we make to dentistry-friendly candidates are what open those lines of communication. It’s what reminds legislators once they’re in office to go directly to the ODA for information, and not somewhere else.

For more information about DENPAC, contact Lynn Means at 800-876-8890 or lmeans@okda.org.

THANK YOU TO THESE 2020 DENPAC GRAND ($1,000) LEVEL MEMBERS! Dr. Douglas Auld

Dr. Robert Herman

Dr. Anaita Mullasseril

Dr. Matthew Cohlmia

Dr. Krista Jones

Dr. Paul Mullasseril

Dr. Richard Haught

Dr. Juan Lopez

Dr. Lindsay Smith www.okda.org

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20 journal | July/August 2020

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Honoring Oklahoma Dental Association's Year Members

Each year, the ODA honors dentists who have been members of the Association for a significant amount of time. Dentists who have maintained their membership for 25, 35 and 50 years are gifted pins to celebrate these milestones.

Due to COVID-19 and the cancellation of our 2020 Annual Meeting, we were unable to honor these members in person this year. However, we still want to highlight the 50-year members and their dedication to organized dentistry. Congratulations to the following on being a 50-year member of the Oklahoma Dental Association!

2020 Oklahoma Dental Association 50-Year Members Dr. George Bridges Dr. Barry Farmer Dr. Don Robison Dr. Doyle Brimberry Dr. Robert Rickey Dr. Floyd Skarky

Dr. D. Michael Spradlin Dr. O. Alton Watson, Jr

How has organized dentistry (ODA Membership) shaped your career in dentistry?

Since the majority of us practice solo or in twos, organized dentistry has given us colleagues in every town and city, wonderful friendships formed at district dental meetings, as well as the yearly state meetings.

What is your favorite memory, moment, or accomplishment in your career?

I was awarded the Thomas Jefferson Award for my work in community service. I have been on the Great Plains Technology Center Board of Education for 45 years. And I am also a father to two practicing dentists in Lawton, Oklahoma, Todd and Trace Bridges.

Dr. George Bridges Lawton, OK Baylor College of Dentistry Class of 1968

What do you see as today’s new dentists’ biggest challenge?

A challenge I see with new dentists today is the massive amount of debt they face, coupled with the expense of opening their practice.

What do you believe is the biggest value that your ODA membership has given you?

Along with high-quality continuing education, the Association has raised the profile and the level of the public’s perception of dentistry.

What are some of the biggest differences in dentistry from when you began practicing to now?

From a pediatric dentistry perspective, there have been noticeable changes in attitudes and expectations regarding behavior management on the part of both dentists and parents.

What is your favorite part of dentistry?

My favorite part of dentistry is treating very young children with advanced dental needs.

What do you believe is the biggest value that your ODA membership has given you?

The ODA and ADA provide representation that far exceeds anything that we might accomplish individually.

Dr. Barry Farmer Muskogee, OK University of Missouri-Kansas City Dental School 2020 22 journal Class of| July/August 1968

What is your favorite memory, moment, or accomplishment in your career?

Marrying my wife, Gayle, 53 years ago.

What are some of the biggest differences in dentistry from when you began practicing to now?

The biggest change in my career can be stated simply in one word: THE COMPUTER! What do you see as today’s new dentists’ biggest challenge?

The biggest challenge that today’s new dentists face is depending too much on technology.

They focus on becoming a “tooth” dentist, instead of becoming a doctor of the entire masticatory system. Learning the art of occlusion is the simple, most important component of dentistry.

Dr. Floyd Skarky Oklahoma City, OK University of Missouri-Kansas City Dental School Class of 1969

What do you believe is the biggest value that your ODA membership has given you?

The ODA has given me a unified, strong voice in the state legislature, a means of continuing education, an annual statewide showcase to see, evaluate, and try out the latest equipment and new dental materials. The ODA’s monthly meetings have encouraged a camaraderie with other ODA dentists and specialists because we learn so very much from each other.

What is your favorite memory, moment, or accomplishment in your career?

I felt pride when patients would return for a cleaning and find my crown and bridgework done on them from the 70’s and 80’s still in excellent condition! During my time in dentistry, I created four dental patents: index trays, a deprogrammer, a handpiece guard, and a dental consultation table.

And most cherished, I developed lifelong friendships with some super patients!

What do you believe is the biggest value that your ODA membership has given you?

The ODA, and of course ADA, has looked out for our interests and protected and enhanced the practice of dentistry.

What are some of the biggest differences in dentistry from when you began practicing to now?

Dentistry has changed incredibly in the past 50 years, from the advances in ability to provide services via new restorative materials and procedures to different restorative services such as implants and other surgical procedures. Delivery of dental services has been enhanced by better auxiliary utilization and I think better care is available through this expanded modality.

What is your favorite memory, moment, or accomplishment in your career?

Dr. D. Michael Spradlin I enjoyed my practice immensely, but since 2010 I have been involved in charitable Tulsa, OK Baylor College of Dentistry Class of 1970

Dr. O Alton Watson, Jr. Oklahoma City, OK University of Missouri-Kansas City Dental School Class of 1968

dentistry and it has captured my heart.

What do you see as today’s new dentists’ biggest challenge?

There are many: economics, practice model, specialty desires, location of practice, etc. that loom larger than they seemed when I began.

What is your favorite part of dentistry?

My favorite part of dentistry was discovering my love for pediatrics. I was not very good at treating children in the beginning, so it was my least favorite thing to do. But with the help of a few friends and dental assistants, I got the hang of pediatrics. It is now my favorite part of dentistry! In fact, for the last 30 years, my practice was almost exclusively children.

How long have you been in practice?

I practiced dentistry for 50 years before retiring in 2019.

What is your specialty?

I specialized in general dentistry but almost totally pediatrics practice for the last 30 years.

The highlighted 50-year members are those who were able to be reached by the ODA before the journal publication deadline.

www.okda.org

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ODA FEATURE

SURVEY OF OKLAHOMA DENTAL PROFESSIONALS ON DETECTING AND REPORTING CHILD ABUSE AND NEGLECT By:Tim Fagan DDS, MS*, Daniel Lander DS4*, Sixia Chen PhD**, and Allison A. Wells** *University of Oklahoma College of Dentistry **University of Oklahoma, Hudson College of Public Health, Mayo Clinic defines child abuse as any intentional harm or mistreatment to a child less than 18 years old.1 While intentional harm and mistreatment are important aspects of child abuse, another component -- neglect -- is often overlooked. Child neglect is defined by the Children’s Bureau of the U.S. Department of Health and Human Services as the failure of a parent or other person with responsibility for the child to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child’s health, safety, and well-being are threatened with harm.2 Child abuse and neglect (CAN) is unfortunately prominent in the State of Oklahoma. In 2017, the Oklahoma Department of Human Services (DHS) received a total of 79,310 CAN reports.

Of these, 35,556 included allegations that met the definitions of CAN and required investigation or assessment.

Since a child can be the subject of more than one investigation, there were 62,828 investigations conducted in 2017; 15,289 (24.33%) were substantiated. Neglect was the highest single category of child maltreatment (87.61%) of substantiated CAN cases; abuse and sexual abuse cases accounted for 9.98% and 3.41%, respectively. Of the substantiated neglect cases, 295 children (1.10%) failed to receive medical attention. Of the abuse and physical abuse cases, 48 children (0.56%) had untreated medical conditions.3 CAN is often first observed by health care providers. However, Oklahoma DHS statistics reveal that they are infrequent reporters of abuse or neglect. In 2017 only 2.91% of reporting came from 26 journal | July/August 2020

nurses or other medical professionals and 0.70% from physicians. Since orofacial trauma is present in 50-75% of all reported cases of physical child abuse dental providers are more apt than other health care providers to see evidence of physical abuse.

In Oklahoma, dental providers are required by law to report suspected cases of CAN. Previous surveys of Oklahoma dentists about CAN reporting requirements4-5 revealed a general lack of knowledge about CAN, with less than a third having ever reported a suspected case of child abuse or neglect. The purpose of this study was to investigate the knowledge of current dental providers about CAN, and to compare the findings with those of previous studies. While respondents to the earlier studies were limited to dentists, the current study included both dentists and dental hygienists as target populations.

Methods and Results Questionnaires were sent to 1,282 dentists and 2,328 dental hygienists in Oklahoma; of these, 290 surveys (123 dentists and 167 dental hygienists) were returned. Of the dental respondents 81% were general practitioners and 19% was distributed among various dental specialties. Table 1 provides a demographic breakdown of the 290 respondents. Table 2 is a summary of survey responses to 18 specific questions; the results are listed as percentages of respondents.

As mentioned, Oklahoma statutes require CAN reporting; failure to do is a misdemeanor.6 While over 90% of both dentists and hygienists are aware of the

CAN reporting requirement, only 49% of dentists and 37% of hygienists were aware of the specific penalty for failing to report. The statutes also provide immunity from civil or criminal liability for reporting CAN cases; they further require that suspected CAN cases be reported to the Department of Human Services. Respondents to the current survey are very aware of the immunity provision and, to a lesser extent, of the DHS reporting provision. For dentists, there appears to be significant improvement in knowledge over the 1991 and 2001 studies.

Perhaps the most surprising statistic was the large number of dentists (44%) that have suspected child abuse or neglect in patients seen in their practices. Just as surprising, only 32% of them reported the incident. As for dental hygienists, 27% suspected child abuse, but only 20% reported it. Given that reporting is legally mandated in Oklahoma these are remarkable findings.

Significance The purpose of this study was to compare not only the level of CAN awareness of dental professionals in 1991 and 2001 to 2019, but also to determine if there have been any differences in reporting behavior. Because craniofacial, head, neck, and face injuries occur in more than half of the cases of child abuse, it is very important that dentists and hygienists have strong awareness and heightened suspicion to any unusual signs of maltreatment and neglect.7 Despite being in a strong position to report such abuse, the results of the present survey indicate surprisingly low reporting numbers. The biggest barrier

to reporting may be a lack of adequate knowledge in the subject. (See responses to Questions 16-18 in Table 2.) More education (and possibly mandatory continuing education on CAN) should be considered in an effort to improve these numbers.

An obvious limitation of this study was the rather low number of respondents.

It is possible that non-respondents may have different opinions or experiences not reflected in this study. Despite this, the study does provide interesting insights into the knowledge, attitudes and compliance rate of Oklahoma dental professionals about reporting CAN.

References 1. Child abuse. (October 2018) (Retrieved December 2019 from https://www.mayoclinic. org/diseases-conditions/child-abuse/ symptoms-causes/syc-20370864) 2. Definitions of Child Abuse and Neglect. (n.d.). (Retrieved December 2019 from https://www.childwelfare.gov/pubPDFs/ define.pdf) 3. Child Abuse and Neglect Statistics State Fiscal Year 2017. (n.d.). (Retrieved January 2020 from http://www.okdhs.org/OKDHS Report Library/S17032_ChildAbuseandNe glectStatisticsSFY2017July2016-June2017_ cwsopoa_03262018.pdf) 4. Mathewson R and Gerety G: Child Abuse and Neglect Awareness: A Survey of Oklahoma Dentists. ODA Journal, pp 30-33, Spring 1993.

ABOUT THE AUTHORS: Dr. Tim Fagan is a Clinical Professor of Pediatric Dentistry at the OU College of Dentistry. He also serves as Head of the Division of Pediatric Dentistry and Chair of the Department of Developmental Sciences at OUCOD. Dr. Daniel Lander was a senior dental student at the OU College of Dentistry at the time this article was written. Upon graduation he entered the Pediatric Dentistry Graduate Program at Virginia Commonwealth University.

Dr. Sixia Chen is an Assistant Professor in the Department of Biostatistics and Epidemiology at the College of Public Health. He is also Director of the Novel Methodologies Unit of Biostatistics, Epidemiology, and Research Design Core of the Oklahoma Shared Clinical and Translation Resources (OSCTR) at the OU Health Sciences Center.

Conclusion 5. Dalzell P, Bajaj R, and Hunter J: Child Abuse The majority of Oklahoma dentists and and Detection and Reporting Behaviors. ODA dental hygienists know that they are Journal. pp 28-32, Spring 2002. required by law to report suspected CAN 6. Oklahoma Statutes, Title 21, Section 845. cases, yet only 32% of dentists and 20% 7. Andreasen JO, Bakland LK, Flores MT, of dental hygienists surveyed complied Andreasen FM, and Andersson L. Traumatic with this requirement when they TABLE 1: Survey Respondent Demographics Dental Injuries: A Manual (3rd ed.).

Ms. Allison Archer Wells is a Master of suspected CAN in their patients. The Hoboken, NJ: Wiley-Blackwell. 2011.

Science degree candidate in Biostatistics results of this survey also demonstrate in the Department of Biostatistics and that Oklahoma dentists and hygienists do Epidemiology, College of Public Health, not feel adequately trained to detect and OU Health Sciences Center. report CAN. Funding for this project was provided by the University of Oklahoma College of Dentistry Student Research Program and the J. Dean Robertson Society, University of Oklahoma Foundation, Inc. Dr. Sixia Chen and Allison A. Wells are partially supported by National Institutes of Health, National Institute of General Medical Sciences [Grant 5U54GM104938-07, PI Judith James].

TABLE 1: Survey Respondent Demographics

Gender Male Female Oklahoma Resident Yes No Race Gender Asian Male Black Female

Hispanic Native American Oklahoma Resident White Yes Other

No

Mean Age

Race Asian Black Hispanic Native American

Dentist

Hygienist

56.1 43.9

1.8 98.2

99.2

Dentist 0.8 1.7 56.1

89.9

10.1Hygienist 1.8

1.8

1.7 43.9 0.8 1.7 92.5 99.2 1.7

1.2 98.2 3.6 8.4 82.6 89.9 2.4

47.5 1.7

43.2

0.8

1.7 0.8 1.7

10.1 1.8

1.2 2 on next page.

Table 3.6 8.4

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27

TABLE 2: Survey Results 1.

As a dentist or hygienist are you required by law to report: QUESTION 1

Only child abuse Only Neglect Both abuse and neglect

2.

40.6% 0.5% 58.9%

Dentist 2001 20.4% 0.3% 79.3%

2019

6.45% N/A 93.55%

Hygienist 2019 7.14% 1.19% 91.67%

A felony charge A misdemeanor charge A reprimand from the Department of Human Services None of the above

1991

Dentist 2001 22.1% 45.7%

2019

27.87% 49.18%

Hygienist 2019

5.1%

9.5%

9.84%

14.37%

22.8%

22.8%

13.11%

19.16%

17.8% 54.3%

29.34% 37.13%

In Oklahoma, are you granted immunity from civil or criminal liability if you report suspected child abuse or neglect in good faith?

QUESTION 3 Yes No

1991

86.2% 13.8%

Dentist 2001

2019

90.4%

94.26%

9.6%

5.74%

Hygienist 2019 86.75% 13.25%

4. To whom would you report suspected child abuse and neglect?

QUESTION 4 Local police dept.

Local DHS office District Attorney None of the above

1991

9.5% 76.8% 13.3% 0.5%

Dentist 2001

2019

10.8%

21.95%

84.9% 4.0% 0.3%

76.42% 1.63% N/A

Hygienist 2019 26.79% 69.05% 0.6% 3.57%

5. Would you define failure to seek treatment for visually rampant untreated dental caries by a parent or guardian as: QUESTION 5 Neglect Child Abuse Both

6.

Neglect Child Abuse Both

85.8% 0.9% 13.3%

Dentist 2001 77.3% 0.8% 21.9%

2019

78.86% 1.63% 19.51%

Hygienist 2019 75% 3.57% 21.43%

1991

69.5% 11.4% 19.0%

Dentist 2001 57.4% 11.4% 31.2%

2019

55.28% 9.76% 34.96%

Hygienist 2019 75% 3.57% 21.43%

In your practice, have you seen or suspected child abuse or neglect?

QUESTION 7 Yes No

8.

1991

Is failure of a parent or guardian to follow through with dental treatment, once informed about the above condition, considered: QUESTION 6

7.

10. Have you taken any CE courses on child abuse and neglect?

QUESTION 10 Yes No

1991

53.7% 46.3%

Did you report the incident?

QUESTION 8 Yes No

16.5% 83.5%

6.6% 93.4%

Hygienist 2019

2019

17.89% 82.11%

26.79% 73.21%

1991

18.0% 82.0%

Dentist 2001

2019

46.9% 53.1%

43.9% 56.1%

Dentist 2001

2019

30.3% 69.7%

32.08% 67.92%

Hygienist 2019 27.38% 72.62%

Hygienist 2019 20.14% 79.86%

11. From what dental school or dental hygiene program did you graduate?

QUESTION 11

1991

Oklahoma College of Dentistry

-

Baylor College of Dentistry

-

Univ. of Missouri, Kansas City Other

Did you receive formal lectures on child abuse at your dental or dental hygiene school?

QUESTION 9 Yes No

1991

38.5% 61.5%

Dentist 2001 41.3% 58.7%

2019

57.85% 42.15%

Hygienist 2019 60.71% 39.29%

Dentist 2001

Hygienist

2019

QUESTION 12 1-4 years 5-9 years 10-14 years 15-19 years 20+ years

2019

Rose State College Tulsa Community 9.4% 4.88% College Oklahoma College 10.1% 2.44% of Dentistry 20.5% 17.89% Other 1%

-

Dentist 2001

1991

10.5% 10.2% 11.3% 20.6% 47.3%

-

14.88%

74.8%

12. How many years have you been in practice?

7.14% 50% 27.89%

2019

Hygienist 2019

2019

Hygienist 2019

14.63% 13.01% 16.26% 13.01% 43.1%

17.86% 16.67% 18.45% 10.71% 36.31%

13. Where do you currently practice?

QUESTION 13 Metropolitan/Urban Rural

Dentist 2001

1991

63.7% 26.3%

-

68.03% 31.97%

61.68% 38.32%

14. In what part of Oklahoma do you currently practice?

QUESTION 14 Central Southwest Southeast Northeast Northwest Not practicing in Oklahoma

QUESTION 15 Prosthodontics Periodontics Pediatric Dentistry Orthodontics Oral/ Maxillofacial Surgery General Dentistry

Dentist 2001

1991

Hygienist 2019

2019

44.2% 9.9% 5.6% 30.3% 47.3% -

-

15. What is your specialty?

43.09% 8.94% 7.32% 34.15% 4.88% 1.63%

Dentist

42.51% 7.78% 7.78% 24.55% 9.58% 7.78

Hygienist

1991

2001

2019

-

1.5% 2.1% 4.7% 4.7% 3.7% 80.7%

1.65% 3.31% 4.96% 5.79% 4.13% 80.17%

2019 Prosthodontics Periodontics Pediatric Dentistry Endodontics Public Health General Dentistry

14.88% 2.41% 50% 0.6% 6.63% 87.35%

16. Have you been trained in P.A.N.D.A. (Prevent Abuse and Neglect through Dental Awareness)?

QUESTION 16

9.

Dentist 2001

1991

Would your failure to report suspected child abuse result in: QUESTION 2

3.

1991

Yes No

1991 -

Dentist 2001

Hygienist 2019

2019

13.6% 86.5%

19.51% 80.49%

15.57% 84.43%

17. How much information have you received from P.A.N.D.A.?

QUESTION 17 Excessive Sufficient Insufficient

1991 -

Dentist 2001

Hygienist 2019

2019

0.4% 17.7% 81.9%

N/A 13.68% 86.32%

1.29% 11.61% 87.1%

18. On a scale of 1 to 10 (with 1 being lowest and 10 highest) how would you rate your level of knowledge of child abuse and neglect?

QUESTION 18 Level of knowledge

28 journal | July/August 2020

Mean 4.93

Dentist Std. Dev. 1.8

Hygienist Mean Std. Dev. 5.38

2.01

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ANTIBIOTIC PRESCRIBING TRENDS AMONG OKLAHOMA DENTISTS By: Krysten Jackson, DDS and Schuyler Pracht, DDS Overprescribing and misuse of antibiotics in the medical field has been well researched and published, but it is not as well studied in the dental field even though general dentists and specialists are the third highest prescribers of antibiotics in an outpatient setting. As is well known, excessive antibiotic use may lead to antibiotic resistance. The Centers for Disease Control (CDC) estimates that antibiotic-resistant infections affect at least two million people and cause 23,000 deaths every year in the United States.1 Knowledge of when and when not to prescribe antibiotics is essential in the fight against antibiotic resistance.

Reports show that 30% - 85% of dental prescriptions are suboptimal or not indicated.2 Antibiotics are indicated for certain inflammatory conditions including cellulitis, periodontal abscess, acute necrotizing ulcerative gingivitis, dental infections with signs of systemic involvement, and pericoronitis.

Conversely, they are not indicated for conditions such as reversible or irreversible pulpitis and hypersensitivity.2 This paper reports on the antibiotic prescribing habits of dental practitioners in Oklahoma using an anonymous 18-question survey generated through Qualtrics and sent electronically to 1,095 licensed Oklahoma dentists and 237 OUCOD dental students. A total of 157 participants returned completed surveys; 79% of respondents were general dentists and 9% were specialists. Some of the more notable results of the survey: On

writing antibiotic prescriptions for dental infections, 10.7% did so daily, 42% weekly, 22.9% monthly, and 20.3% “hardly ever.�

For pain, 27.4% of participants reported that they would prescribe antibiotics. The most reported situations for prescribing antibiotics were for orofacial infections with signs of systemic involvement (87.9%), dentoalveolar abscesses (75.8%), and periapical abscesses (70.7%).

Most of the participants reported awareness of current guidelines for antibiotic prescribing. Nearly all prescribers (95.5%) reported that they informed their patients of the risks of noncompliance with their antibiotic regimens.

A very small number of respondents (0.04%) stated that they did not believe that an overdose of antibiotics could lead to resistance. In summary, the majority of practitioners reported appropriate antibiotic prescribing practices, but it is important to keep current with continuing education in this area to reduce the propagation of antibiotic resistance.

REFERENCES 1. Roberts, RM, et al. Antibiotic prescribing by general dentists in the United States, 2013.

JADA, 148(3), 2017.

2. Lockhart, PB, et al. Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapicalrelated dental pain and intraoral swelling.

JADA,150(11), 2019.

3. Dar-Odeh, N, et al. Antibiotic prescribing practices by dentists: a review. Therapeutics & Clin Risk Mgmt, p. 301, 2010.

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30 journal | July/August 2020

4. Durkin, MJ., et al. Longitudinal antibiotic prescribing trends among US dental specialists within a pharmacy benefits manager, 2013 through 2015. JADA,150(10), 2019.

5. Salako, NO, et al. Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait. J Dent, 32(7): 503 509, 2004.

ABOUT THE AUTHORS: Dr. Krysten Jackson is from Lawton, Oklahoma.

She completed her undergraduate studies at Cameron University in Lawton, where she received a Bachelor of Science degree in Cell and Molecular Biology with a minor in Chemistry. She is a 2019 graduate of the University of Oklahoma College of Dentistry, and is currently completing a one-year AEGD residency at OUCOD. She plans to practice in the Oklahoma City area.

Dr. Schuyler Pracht was born and raised in Lindsay, Oklahoma.

She received Bachelor of Science degrees in Biochemistry and Molecular Biology and Microbiology at Oklahoma State University. She received her DDS from the University of Oklahoma College of Dentistry in 2019 and is currently in the AEGD program at OUCOD. She would eventually like to own her own practice in or close to Tulsa, Oklahoma.

PRACTICALITY AND EFFICACY OF PERIODONTAL TRAYS AS AN ADJUNCTIVE THERAPY By: Cama Cord, DDS and Jacob Rhodes, DDS The maturation of bacterial biofilm, particularly the progression towards intermediate and late colonizers, plays an important role in periodontal disease. Ultimately, the progression of disease can create irreversible damage as inflammation and bone loss occur.

Conventional treatment of periodontal disease ranges from non-surgical scaling and root planing to grafting and open flap debridement. Yet, mechanical therapies have their limitations2. Researchers and dentists have tried different forms of topically applied medications to assist in treating periodontal disease. In recent years, delivering low-concentration hydrogen peroxide, with or without antibiotics, via custom fabricated trays has increased in popularity. When deciding whether or not to implement such therapies, it is imperative that dentists understand the appropriate circumstances in which to utilize them and recognize their limitations.

The simplicity of perio trays allows patients to take a proactive approach in improving their oral health. This is accomplished by using custom-fabricated trays at home with 1.7% hydrogen peroxide gel for approximately 10-15 minutes of treatment time. The frequency of treatment and antibiotic usage can be customized to each patient’s individual needs.

For the practitioner, perio trays are a non-invasive treatment option for the delivery of traditional Phase 1 periodontal therapy. Such adjunctive treatment has been shown to provide beneficial effects on periodontal disease, and could serve as an important measure to prevent aggressive periodontal surgery. Due to their simplicity, perio trays also have the potential to elicit higher treatment acceptance in patients averse to surgical therapies. In this way, hesitant or fearful patients are able to exhaust all noninvasive treatment options prior to accepting surgical therapies.

This literature review investigated the efficacy of periodontal medicaments

delivered via custom trays. Several databases were searched including PubMed and Cochrane. The studies examined suggest that periodontal trays enhance outcomes of non-surgical scaling and root planing. Clinical trials conducted

by Putt et al.7-8 found that probing depths decreased by 0.13 mm without perio trays and 0.77 mm with perio trays at the three-month post-scaling/ root planing treatment mark. After six months probing depths decreased by 0.55 mm without perio trays and 1.50 mm with perio trays. Additionally, it has been found that customized trays are able to deliver medication to a depth of 9 mm, allowing for treatment of severe periodontal pockets.3 Improvements in periodontal bleeding have also been found with significant reduction in bleeding on probing.1,5,7 Lastly, adjunctive use of perio trays has been shown to decrease the bacterial load and change the microbial environment. Notably, it was found that hydrogen peroxide, along with doxycycline (a tetracycline antibiotic), reduced the gram-bacterial load, allowing for beneficial bacteria to recolonize. Results were maintained for approximately 3 months.4 Ultimately, the goal of perio tray therapy is to assist in healing the periodontal support structures, leading to a healthier periodontium that can be maintained by the patient.

To summarize, dental professionals have the responsibility to provide treatment that not only benefits the patient, but also aligns with their goals and desires. Since many patients are hesitant or unwilling to undergo aggressive surgical treatment, dentists would be wise to inquire about this new method for treating and maintaining periodontal disease, which has shown to have beneficial, non-invasive therapeutic effects.

REFERENCES 1. Cochrane RB and Sindelar B. Case Series Report of 66 Refractory Maintenance Patients Evaluating the Effectiveness of Topical Oxidizing Agents. J Clin Dent 26:109-114, 2015.

2. Collin F and Veis R. Periodontal treatment: The delivery and role of locally applied therapeutics. Cont Dent Ed Digest 14-21, 2006.

3. Dunlap T, Keller DC, Marsah MV, et al.

Subgingival delivery of oral debriding agents: a proof of concept. J Clin Dent 22(5):149-158, 2011.

4. Keller, DC and Buechel, M. Direct medication delivery modifies the periodontal biofilm. Oral Biol Dent 5:1, 2017.

5. Keller, DC and Buechel M. Periodontal treatment with direct medication delivery of hydrogen peroxide and oxygen. Oral Health Case Report 3:133, 2017.

6. Lasserre JF, Brecx MC, and Toma S. Oral microbes, biofilms and their role in periodontal and peri-implant diseases. Materials (Basel) 11(10):1802, 2018. (Published 2018 Sep 22. doi:10.3390/ma11101802) 7. Putt, MS and Proskin, HM. Custom tray application of peroxide gel as an adjunct to scaling and root planing in treatment of periodontitis: a randomized, controlled, threegroup clinical trial. J Clin Dent 23(2):48-56, 2012.

8. Putt, MS and Proskin, HM. Custom tray application of peroxide gel as an adjunct to scaling and root planing in the treatment of periodontitis: results of a randomized controlled trial after six months. J Clin Dent.

24:100-107, 2013.

ABOUT THE AUTHORS: Dr. Cama Cord was raised in Yukon, Oklahoma and is a 2019 graduate of the OU College of Dentistry. After her AEGD residency at the OU College of Dentistry, she plans on joining a private practice in OKC and is looking forward to serving the OKC community. Cord loves to spend time outdoors with her husband of five years and their new baby daughter (and their German Shepherds).

Dr. Jacob Rhodes is a native Texan and a 2019 graduate of the University of Texas School of Dentistry at Houston. After completion of his AEGD residency at the OU College of Dentistry he plans to return to southeast Texas and join a group practice providing quality, comprehensive care to the community. Jacob enjoys hunting, fishing, and spending time with his wife and their two sons.

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ATRAUMATIC EXTRACTIONS By: Katie Higgins, DDS and Jeremiah Aigbedion, DDS Implants are becoming a more common and accessible treatment for patients with missing teeth. The term “atraumatic extraction” has been used to describe an extraction that preserves the most threedimensional bone and soft tissue contours, once the tooth is gone. With implant placement, the dimensions of the bone and soft tissue are important not only for the implant itself, but also for the outcome and longevity of the final restoration.

Several methods of atraumatic extractions have been proposed over the years. The following literature review summarizes the most commonly used techniques and some of the advantages and disadvantages of each.

Atraumatic extractions can still be achieved with traditional methods, with only minor changes in technique. To create a good surgical plan and identify areas that might pose difficulty, the radiographs and clinical presentation of the tooth must be reviewed prior to extraction. Good elevation and luxation is used prior to attempting to remove the tooth with forceps. Elevation of a gingival flap can aid in visualization; however, it does create a small amount of bone loss.

Sectioning of multi-rooted teeth is always advised to reduce pressure on the bony walls of the socket during root removal.

Many different techniques have been explored to aid in atraumatic extractions.

A PubMed search was conducted for articles on studies of novel extraction methods, including ortho extrusion, piezosurgery, the Benex System, and implant drills. An article on traditional extraction methods was also included.

Ortho extrusion: Extrusion via orthodontic bands has a variety of applications. It can be especially beneficial in the anterior esthetic zone to preserve bone and soft tissue contours. Some disadvantages: the time of treatment and the need to wear orthodontic appliances.

Piezosurgery: Ultrasonic handpieces have many applications in dentistry. In a case study using a sonic instrument for bone surgery (SIBS) the piezo instrument was used to loosen the periodontal ligament to aid in extractions. Advantage: it may 32 journal | July/August 2020

reduce surgical time for the extraction.

Disadvantage: possible breakage of the instrument within the socket.

Benex System: This system is a novel extraction device that uses traction to remove a condemned root. A study of 72 patients with decayed teeth or root remnants that had their teeth extracted using the Benex System showed higher success rates with single-rooted teeth vs. multi-rooted teeth. Extraction failures with the system are most associated with lack of retention, misplacement of screws, and root fracture.

Implant Drills: Immediate implant placement is becoming more common due to the reduced treatment time for the patient. A more prompt esthetic result can also be achieved with immediate fabrication of provisionals. A case study was reviewed where implant drills were used to thin root walls so they could be removed more easily with elevators.

Advantage: decreased treatment time.

Disadvantage: not every patient has a situation that would be conducive for an immediate implant.

The term “atraumatic” is an interesting way to describe an inherently traumatic procedure. However, it is helpful to be reminded that bone and soft tissue present around the natural tooth is precious.

Each atraumatic extraction technique has a clinical case where its use can be efficacious. Using implant drills to aid in removal of the root prior to placement of an immediate implant seems the most practical. Due to its extended time involvement orthodontic extrusion is the least practical; however, it may be applicable in some cases where esthetics is a concern. The Benex system and piezosurgery seem the most problematic given that they require the use of nonstandard equipment. However, if the dentist feels that either of these systems is applicable in a certain situation, then it can be prudent. Regardless of technique used the most important factor is ensuring that as much bone and soft tissue is preserved as possible to create the best outcome for the patient.

Each extraction technique has its own unique benefits and drawbacks and, depending on the situation at hand, may not be as practical or beneficial to the patient as the traditional method of extraction. As the use of implants becomes more common, the use of atraumatic extraction techniques will receive increasing attention.

REFERENCES 1. Kubilius, M, Kubilius, R, and Gleiznys, A. The preservation of alveolar bone ridge during tooth extraction. Baltic Dent and Maxillofac J, 14(3), 2012.

2. Papadimitriou, D, Geminiani, A, Zahavi, T, and Ercoli, C. Sonosurgery for atraumatic tooth extraction: a clinical report. J Prosth Dent, 108(6), 2012.

3. Serhat, Y, Irem, A, Yusuf, E, Gul, K, Buket, A, and Belir, A. A technique for atraumatic extraction of teeth before immediate implant placement using implant drills. J Internatl Cong Oral Implantol, 18(6), 2009.

4. Regev, E, Lustmann, J, and Nashef, R. Atraumatic Teeth Extraction in Bisphosphonate-Treated Patients. J Oral and Maxillofac Surg, 66(6), 2008.

5. Muska, E, Walter, C, Knight, A, Taneja, P, Bulsara, Y, Hahn, M, and Dietrich, T. Atraumatic vertical tooth extraction: a proof of principle clinical study of a novel system. Oral Surg Oral Med Oral Path Oral Radiol, 116(5), 2013.

ABOUT THE AUTHORS:

Dr. Kathleen Higgins was raised in Lincoln, Nebraska, and attended the University of Nebraska-Lincoln where she majored in Biology. She then attended the University of Nebraska Medical Center College of Dentistry and graduated with her DDS degree in 2019.

She is currently a resident in the OU College of Dentistry’s AEGD (Advanced Education in General Dentistry) program. Excited about the continuing advancements in technology Higgins is looking forward to a lifetime of dental practice.

Dr. Jeremiah Aigbedion was born in Nigeria, and relocated to Houston, Texas with his family when he was four years old. He attended the University of Houston for four years before entering the Texas A&M College of Dentistry, graduating with his DDS degree in 2019. He is currently enrolled as a resident in the OU College of Dentistry’s AEGD program. After the completion of the AEGD program, he plans to move back to Texas and practice in the Houston area.

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33

HOW DO WE RESPOND TO THE “NEW NORMAL”?

By: Tabitha L. Arias, DDS The year 2020 has already proven to be one we will never forget. This time in our lives has continued to be one of great difficulty and challenge. Over the last few months, we’ve all been overwhelmed by feelings of fear, uncertainty and an overall sense of being lost as we’ve navigated through the pandemic and division in our world. As a people, a community and a country we are broken and we need each other more than ever. Our families, our patients and our communities are dealing with numerous challenges related to health, race, economic hardship and civic chaos. Sadly, for many it has been too much to bear. A colleague with whom I had served in dental missions recently took her own life. She was such a bright light and blessing to all those she touched.

Her death continues to weigh on my heart as I think about how these current events affect those we love and those we serve as dental care providers.

After a six-week closure, my patients have started to return to their scheduled routine appointments, and I have found it is not just dentistry we are providing.

Many are looking for comfort after losing a job or a home due to the pandemic.

Others are looking for guidance as they try to find a “new normal.” For many this is their first trip out of their homes after three months of isolation; my office is their first point of contact and connection.

With each encounter I feel the weight of all that my patients are going through.

focus on your health -- especially your mental health. We have to take care of ourselves before we can care for someone else. We pour so much into our patients every single day that at times it can feel like we have no more to give. I would also encourage you to reach out and see how you can get connected and involved. Your patients, your team and your community will be looking to you for guidance. There are so many resources available for you to feel equipped and supported to serve your communities.

It is clear to me that we are being called to provide so much more than dentistry to our communities. Our world and the way we provide care to our patients is changing. As I’ve transitioned from dental student to practicing associate, and now to a new practice owner, my involvement in organized dentistry has proved pivotal in helping me guide my practice, my patients and my team. I’ve received many opportunities to serve over the years that have bettered me as a provider and enabled SEARCHING FOR YOUR NEXT me to feel supported, LEADERSHIP OPPORTUNITY? especially during times like these. Last year I had the honor of being selected to participate in the Oklahoma Dental Association’s Leadership Academy, an opportunity that allowed me to dive deeper into not only how organized dentistry was serving me as a provider, but also how I could serve my profession and lead LOOKING TO BECOME MORE INVOLVED the future of dentistry.

IN ORGANIZED DENTISTRY? The time to get connected is now.

Lastly, it is important to recognize that as care providers we may be our patients’ greatest comfort during these difficult times. We get the opportunity to serve them and our communities in a very special and personal way. We are the first faces many are seeing after their time in isolation; this gives us an unparalleled opportunity (and awesome responsibility) to provide needed comfort, reassurance and a sense of normalcy. There is still much that remains unknown as we move forward, but I hope we can continue to be a guiding and encouraging light to all those who give us their faith, trust and reliance. We all remain in this together.

Look no further than ODA’s Leadership Academy where you will develop the skills and tools to become a successful leader in organized dentistry through a series of courses, speakers and events. Now Accepting Applications! Learn more and apply at okda.org

34 journal | July/August 2020

Isolation may not be a new feeling for some of my colleagues. For many, dentistry in itself can be isolating. So now is the time to invest in you. I would encourage you to put dedicated

ABOUT THE AUTHOR: Dr. Tabitha Arias is a 2017 graduate of the University of Oklahoma College of Dentistry.

While at OUCOD she served as president of the College’s chapter of the American Student Dental Association (OUASDA) and chair of the National ASDA’s Council on Communications.

Arias is currently serving as vice president of the Oklahoma County Dental Society and as the Oklahoma Dental Association’s New Dentist Trustee. She is a member of the Oklahoma Dental Association, the American Dental Association, the American Dental Education Association, the Academy of General Dentistry, and the American Dental Political Action Committee. She owns her own general dentistry practice in Oklahoma City.

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35

Collect What You Produce:

EFFECTIVE FINANCIAL COMMUNICATION By: Cathy Jameson, PhD | Part 5 of a ten-part series “Great communication makes it easier for doctors and teams to let patients know the benefits of patient financing and can encourage a patient to move forward with needed care.” – Doug Hammond (Senior Vice President/General Manager, CareCredit) According to an ADA survey, fear of the cost of dentistry is the main reason that people [1] do not go to the dentist on a regular basis or [2] do not proceed with recommended treatment. If you track your diagnosed but uncompleted dentistry, you’ll likely find a lot of potential treatment sitting in your charts waiting to be done. Most practices can substantially increase productivity simply by nurturing that which they already have -- their existing patient family. If more of those patients were saying “yes” to treatment, your practice’s bottom line would obviously be positively affected.

Part 3 of this series referred to a nationwide ADA survey that posed the question, “If you needed to make a onetime dental purchase of $500, could you?”

Seventy-seven percent of respondents said “no” -- unless insurance paid for it or they had some way to pay it out over time. If one patient per day proceeded with $500 worth of treatment over the 200 days that most practices are open, your practice would realize up to $100,000 annually of increased productivity. While about 20% would be earmarked for supplies and lab work, that still results in $80,000 of increased income.

People come to your practice because they need or want something. For many of them, however, without a financial agreement no appointment will be scheduled and no treatment provided.

No one wins. The financial agreement is the “moment of truth” in your practice.

Everyone on your team must believe that if a patient walks out the door without scheduling an appointment because there’s no financial agreement, both your practice and the patient have lost.

36 journal | July/August 2020

ESSENTIAL ELEMENTS OF THE FINANCIAL DISCUSSION There are three essential elements of a professional financial discussion: 1. KNOWLEDGE OF PRODUCT AND SERVICE Your Financial Coordinator (FC) must be comfortable answering clinical questions: what is being recommended and why; how long each appointment will last; and who bears the financial responsibility. The FC’s knowledge of and support for your recommendations may make the difference in whether the patient proceeds with treatment. In addition, patients may ask your FC questions they won’t ask you.

It is critical that all clinical questions be answered before a discussion of money takes place. However, the financial presentation is equally important as the clinical presentation. Just because the patient agrees to treatment doesn’t mean the case is closed. It can be considered closed only when the patient and your practice come to a financial agreement on (1) the total investment and (2) method of payment.

2. IN-DEPTH KNOWLEDGE OF MONEY AND FINANCING Your FC must understand all financial options and be able to discuss money comfortably, handle objections and not give up until a financial agreement has been established.

Financial communication involves a specific set of skills that must be taught, learned and practiced. Bring in the best people to teach your team. Also, people don’t learn something once and never need an update. Repetition is the key to skill mastery. Just one patient saying yes to treatment can more than pay for the training.

3. COMPLETION OF ALL NECESSARY DOCUMENTATION Your FC must be able to obtain a written and signed financial agreement, handle insurance issues, and manage the patient financing program with skill and confidence.

This requires preparation and having all necessary adjunctive materials

(photographs, other visual aids, etc.) available. Verbal communication skills are extremely critical. Any lack of preparation will be noted by the patient and could jeopardize any agreement.

EFFECTIVE FINANCIAL ARRANGEMENTS To arrive at an acceptable financial agreement, you should give attention to the issues of privacy, HIPAA compliance, and lack of interruptions.

Privacy. Conduct financial discussions in a private setting, certainly not at the front desk where other people may hear the conversation. A lack of privacy may result in a patient becoming embarrassed and scheduling an appointment without any intention of showing up. The patient may also be uncomfortable discussing concerns about fees, and may not want to ask about financial options for fear of others overhearing the conversation.

HIPAA Compliance. The HIPAA Privacy Rule establishes national standards that protect individuals’ medical records and other personal health information including financial arrangements.

Patient privacy must be protected when conversations about treatment or finances are conducted.

Avoid interruptions. If there are interruptions during financial discussions, focus can be lost, patients get frustrated, and the possibility of mistakes increase.

This can result in misunderstandings and disgruntled patients who weren’t adequately informed of financial responsibility in advance, which could result in poor future collections.

DISCUSSING MONEY While it may be natural to some patients to open a discussion with questions about cost, they don’t yet know what they are buying. Discussing money too quickly can be detrimental. And quoting a fee too early may be worse than not quoting a fee at all!

If a patient asks you about money at the beginning of your consultation, you should gently refocus on the desired

goals of treatment. Acknowledge their concerns, but keep the money questions where they belong – after the clinical presentation. If you discuss finances first, the patient will not hear a word you say.

They will only be thinking about the cost.

PRESENTING A PATIENT FINANCING PROGRAM Since a person’s behavior is often driven by self-interest, present your financing program in terms of how it will benefit the patient. Moreover, what you say may not make as much of a difference in decision-making as how you say it.

Patient financing is a great service to patients and to the profession. However, you may encounter some objections from patients. Tom Hopkins, a noted speaker in communication training, says that an objection is a request for further information, which indicates that the person is interested in your proposal. In other words, if they don’t ask questions and/or present any objections they may not be interested in your offerings.

You should identify those “normal” objections you might hear, and determine effective ways to handle and overcome them with positive responses. Build the patient’s confidence by presenting the value and benefit of the program.

Acceptance will be in direct proportion to the quality of your presentation.

SUMMARY The way you communicate makes all the difference in the world. It is the bottom line to your success -- or the lack of it.

Financial communications with your patients should be very personal and private conversations. Be gracious and enthusiastic.

Once you become involved with a patient financing program, learn how to present it, explain its benefits, and work to address and overcome any patient objections. The end results of these efforts will be higher levels of case acceptance and greater personal satisfaction.

ABOUT THE AUTHOR: Cathy Jameson, PhD, is

the founder of Jameson Management, Inc., an international management, hygiene, and marketing firm which offers proven management and marketing systems for helping organizations improve in a positive, forward-thinking culture.

Jameson holds a doctorate in management from Walden University where she focused her research on transformational leadership.

She has been inducted into the College of Education Hall of Fame and is a Distinguished Alumna of Oklahoma State University. She serves on the Board of Governors there.

Jameson has been named one of the top 25 Women in Dentistry and has received Lifetime Achievement Awards from the Excellence in Dentistry Organization and from the Academy of Dental Office Managers. She was a finalist for the Stevie Award for outstanding entrepreneurial women. She is a member of the American Association of Female Executives, National Speaker’s Association, Academy of Dental Management Consultants, National Society of Leaders and Success and Chi Omega Women’s Fraternity.

Jameson has lectured in all US states and in 31 countries. She has had over 1,500 articles published throughout the US and the world.

She is the author of eight books, including the 3rd Edition of her bestseller, Collect What You Produce and Creating a Healthy Work Environment. These can be purchased from Amazon.

For more information on Dr. Jameson’s lecture or personal consulting services, contact her at Cathy@ jamesonmanagement.com. For more information on the consulting services of The Jameson Management Group, contact www.info@jamesonmanagement.com or www.jamesonmanagement.com

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37

HYGIENE HOTSPOT

ADJUST – ADAPT – OVERCOME By: Dawn Wilson, RDH By now, we are well on our way to reopening our practices and discovering the triumphs and tribulations of reemerging from the safety of our homes and figuring out how to safely get back to work.

As the country began to shut down at the onset of the pandemic, we all experienced a rainbow of emotions. The anxiety of being unemployed became real. I never thought it was possible. I would joke around and say things like, “As long as there are teeth, I will always have a job.” Unless there is a pandemic, of course. Who would’ve thought I would be forced to stay at home, unable to do my work? Not me, not ever.

It was especially hard hearing that dental hygienists were deemed non-essential, which literally left me scratching my head. That stung. A lot. I often asked, “Says who?” While our profession is primarily preventative in nature, I’ve never considered what I do as non-essential and elective. It is true we do not perform life-threatening procedures but what we do is important and essential for people and their overall health. Isn’t that what we’ve been teaching all these years? Good oral health leads to better overall health?

I settled into staying home trying not to let the media get to me because it was all very scary to watch and it got me thinking: What would dentistry look like post-pandemic? How would our universal precautions protocols adjust? We’ve learned that COVID-19 is highly infectious, spreads rapidly through the respiratory system, and is sustainable. While performing dental procedures, we are in close proximity for extended periods of time and often produce aerosols so, knowing a little more about the virus, we understood our jobs involved a higher level of risk and required additional precautions. Yes, there was and will likely continue to be an abundance of caution for a while because we don’t know enough about THIS virus just yet.

Being a carrier of a virus and unaware of it is not new; we’ve just been reminded again of its mystery. Take HIV, for example. It took two years to name it and four years after that before they had an attempt at treatment. What I remember most during that time was the advice given to the public based on what they thought they knew about HIV: don’t drink after anyone because you might “catch it,” don’t shake hands, no kissing, etc.

I even remember something about it being transferred through tears! That virus changed dentistry forever because clinicians began wearing gloves. That must have felt pretty drastic to many clinicians and I’m sure they also experienced that awkward adjustment period. Soon dentistry made “universal precautions” its new normal except when treating HIV-positive patients; we had a different set of procedures for them if we knew their HIV status. Operatories wrapped in plastic, no ultrasonic, double-

38 journal | July/August 2020

gloving, triple sterilization for instruments, extra sanitizing of anything they touched, double masks and face shields, just to name a few. Seems a little extreme, right? Kind of like now.

Unfortunately, most people didn’t know they had HIV or didn’t tell us for fear of being judged and not being treated. (And yes, that still happens today in the 21st century. People are still occasionally turned away from dental treatment for being honest about their HIV status.) We navigated through that time and we will find our way through this period with a renewed perspective.

My approach is to treat everyone as if they have something that can be passed on to me or to the next person, and I do my best to prevent that from happening. You must protect yourself, your family and your patients. Commit yourself to lifelong learning.

Listen to the scientists; they are the experts. Study the data as it becomes available. This is a coronavirus, one of seven so far; it certainly won’t be the last. Most of all, remind yourself that for the most part we are treating healthy patients.

Dentistry is not for the faint of heart and will always be a highrisk profession. We accepted this risk from the day we recited our professional oath. We have to roll with it because it changes fast and often. Have the flexibility of a cat or dog (depending on your yoga preference) and maybe stretch your neck out there to do amazing things in dentistry. Change will always be there for you -- it just depends on how you greet it.

Simply stated: Adjust. Adapt. Overcome.

ABOUT THE AUTHOR: Dawn Wilson RDH, BA is a 1993 graduate of the Tulsa Community College dental hygiene program. Since graduation, she has worked clinically all over Oklahoma in both general practice and periodontics, and overseas in Doha, Qatar. She and her husband, Tim, celebrated their 25th wedding anniversary earlier this year with a trip to their favorite beach.

When the Wilsons aren’t traveling, they stay active volunteering and fostering dogs for Lab Rescue of Oklahoma; they have two fur babies of their own. Currently residing in Stillwater, they are both avid OSU fans and look forward to the day sports will start up again -- especially football!

NEW DENTIST CORNER

A NON-TRADITIONAL PATH TO DENTISTRY By: Elizabeth K. Silver, DDS In these last few months, we’ve been told time and again that the Class of 2020 will forever be remembered for our unique entry into dentistry in the time of COVID-19. Our senior year bears little resemblance to those of the classes that came before us, and nothing has gone as anticipated. We had no senior events, no graduation ceremony, nothing to mark this achievement or transition -- not even the licensing exam for which we prepared.

However, the date on our diplomas reads May 25, 2020. This means that I am finally and officially, with neither pomp nor circumstance, Elizabeth Silver, DDS.

financial security. I’d never tried it before, but it really sounded good.

As the first in my family to achieve this distinction, I’ve spent this time (originally set aside for celebrating) in socially-distanced reflection. As a “non-traditional” student, older than my classmates and with a different lived experience, I’d like to share my story:

The main prerequisite for dental school is, essentially, a bachelor’s degree in hard sciences, and I had no science background.

I wasn’t even sure I could succeed in a science class. So in December 2011, I sold some jewelry on Craigslist, took the cash to OCCC and enrolled in an introductory biology course.

It went well! A semester or two later found me driving to UCO in Edmond every weeknight for more advanced courses. I went to class every weeknight (and every day during the summer), working my way through the natural sciences and finding myself thriving. I would get home from work at around 4:00 pm, trade my teacher clothes for jeans and my work bag for a backpack, and blaze up Broadway Extension, trying to beat the traffic to make it to my 5:00 pm class. I’d get home around 11:00 pm and be back teaching at 7:30 am. This was my life for over four years.

In the throes of a quarter-life crisis at the age of 25, I was searching for something I couldn’t quite grasp. I was teaching high school, and while I enjoyed it, I knew it wasn’t what I wanted to do forever. For one thing it is almost impossible to be economically secure as a teacher. For another, it wasn’t my calling, and to be an effective teacher in a nation that does not value teachers, you need that passion. I kept trying to drill down on what I wanted to do and who I wanted to be when it hit me that I was asking myself the wrong questions.

The question I should have been asking was, “Who do I want to have been?”. At the end of my life looking back, what do I want to have accomplished? What would make me proud and satisfied?

So I made a list and worked backward from there.

I knew I wanted to learn science. My bachelor’s degree is in Letters (history, philosophy, literature, and modern and ancient languages), and while I value my Humanities education, I felt that I was missing out on a whole area in which I could be the obnoxious “fun fact!” smarty pants that I loved to be. So item one: do something that makes me learn all of science. Dissections were always my favorite part of science classes, so the more knives and macrostructures involved, the better.

I’ve always loved working with my hands and I’m skilled at small detailed work. I’ve been sewing since I was young. I love crocheting and crafting and anything else that keeps my hands busy. Item two: work with my hands in some way.

Item three: Get to be called Dr. Silver in some professional capacity. I just like the sound of that.

Item four: Do some good. The best part of teaching was those tiny moments when you know that someone’s life is a little bit better because you were there for them in some way. I wanted my energies to benefit my community and give me that feeling of peace and satisfaction.

Item five: Get paid, at least enough to meet my needs and never depend on others. I wanted to breathe the cool, placid air of

In a huge twist that no one, including me, saw coming, I discovered that Dentistry was the one profession that checked every box. My mother was the first to bring it up. I didn’t know any dentists personally, but the more I learned, the more certain I was. I had never before felt that clear, clean click of a puzzle piece that comes from finding your path. It was time to take the first step.

Gradually my “How To Get Into Dental School” items were checked off. And then I got an interview. And then I got my acceptance letter. And then I started. And then I cried and stressed and raged and complained and studied and ate and caffeinated and met some amazing people and met some infuriating people and dissected and drilled and numbed and cleaned and pulled and succeeded and failed and had so many exhilarating, intoxicating firsts and triumphs, all of which confirmed that I was in the right place.

After seven years of teaching, four and a half years of night school, four years at the OUCOD, and so much strife and doubt and sacrifice and truly shocking fetch-the-smelling-salts amounts of student debt, I can say without doubt that the last nine and a half years of my life have been absolutely worth it. I have felt so much pride, joy and love during this time. I’ve learned to lean on those who love me, and I’ve learned that it’s never too late to change your own life.

ABOUT THE AUTHOR: Dr. Elizabeth Silver was born and raised in Oklahoma City. After graduating with a BA in Letters from the University of Oklahoma in 2008, she taught for seven years at Harding Charter Preparatory High School before attending the OU College of Dentistry. Having graduated first into a recession, and second into a pandemic, she is starting to question her luck. She resides in Oklahoma City with her husband, Chris Dearner, and is in the process of purchasing her mentor’s general dentistry practice in central Oklahoma City.

39 www.okda.org

Congrats Class of 2020!

WE CAN’T WAIT TO SEE WHAT’S NEXT.

Amanda Akkari Tarek Alanbari Amber Bewley Whitney Brannan Austin Brasher Allison Brewer Tendai Dandajena Mason Davis Linda Dinh Dylan Droege Gabe Duffy Christopher Eaton Ahmed Elsherifmed

Cheryl Fleming Stefan Gelvin Jacy Glover Alin Gorgan Korbin Hally Brittany Hand Steven Hassenplug Bree Highstrom Jeremiah Hilton Chris Hunt Berlian Jeffery Ayesha Kashif Kiranjot Kaur

Mandeep Kaur Gaganjot Khera Addison Kirkpatrick Olga Kvitkina Daniel Lander Amy Le Kate Littlefield Tara Littlefield Benjamin Lloyd Samuel Lloyd Ashley Long Madeline Lynch Ambica Mallipeddi

Kyle Michelson Shawn Moffet Samirah Mohamad Blake Neece Randy Patterson Jordan Pierce Ali Rahill Moumita Saha Nathan Sethman Graham Shadwick Shuhad Shambille Saurabh Sharma Taylor Short

Elizabeth Silver Sara Siraj Kaylee Speer Mary Temple-Goins Meridith Tinnin Saumya Vullaganti Benjamine Welch Jeff Wilson Phillip Worthen Peter Yao

2019 OKMOM

(Front Row Students L to R: Jordan Pierce, Cheryl Fleming, Madeline Lynch, Brock Shaw, Linda Dinh; Back Row Students L to R: Blake Neece, Austin Welch, Ali Rahill, Berlian Jeffery, Tendai Dandajena, Jacy Glover, Kyle Michelsen)

2019-2020 ASDA Officers and Members

(Students L to R: Dylan Droege [Treasurer], Berlian Jeffery [Publications Editor], Ashley Long [Historian], Mary Temple-Goins [Vice President], Brittany Hand [President], Jacy Glover [Secretary], Cheryl Fleming [Vendor Coordinator], Kaylee Speer, Elizabeth Silver, Gabe Duffy [Legislative Liaison])

40 journal | July/August 2020

Annually, the senior student body recognizes OUCOD teaching and staff services.

Congratulations to the following: Outstanding Full-time Faculty Dr. Nancy Jacobsen

Outstanding Department Division of Implantology

Outstanding Staff Member Mr. Kevin Hoang

Congratulations to the 2020-2021 OU ASDA Officers President Jamie Watson

Treasurer Sam Austin

Publications Editor Ali Agee

Vendor Coordinator Michael Bogran

President-Elect Lauren Kaufmann

Secretary Noor Al-Makda

Historian Emily Brooks

Vendor Coordinator Teighlor Juricek

Vice President Treyon Grant

Membership Coordinator Jennifer Dinh

Legislative Liaison Clark Oakley

Vice President- Elect Annie Jordan

Congratulations to the ASDA Award Winners

Michael E. Lindley Award Cheryl Fleming

National Award of Excellence Brittany Hand

www.okda.org

41

Why EVERY Prescription Should Be an ELECTRONIC Prescription By: Robert McDermott, President & Chief Executive Officer January 1, 2020, Oklahoma dentists are required to electronically prescribe nearly all controlled substances. With this law in effect, pharmacies no longer accept Schedule II-V prescriptions by paper, phone or fax, unless you have been approved for a short-term extension waiver.

While it may feel cumbersome to have another legal mandate to deal with, the right ePrescribing tool improves patient care as well as your entire prescription process. The law is an opportunity to take advantage of a better way of doing business. Here are a few factors to consider as you make the switch.

Maximize your ePrescription service.

Choose a service that allows you to ePrescribe ALL medications, including controlled substances. Unifying your process for all prescriptions reduces errors and time spent on prescribing.

Integrate with Oklahoma PMP AWARE. An important efficiency function of an ePrescribe tool is direct integration with Oklahoma PMP AWARE. Normally it can take up to five minutes and dozens of clicks to do a patient history check through the PMP AWARE site.

An ePrescribe software built for easy integration with PMP AWARE allows you to check a patient’s prescription history with just one or two clicks.

Keep your workflow.

The workflow is similar to paper. Your staff can still prepare the prescription.

You still review and approve. Then it’s sent with a click. You can further maximize ePrescription efficiency with a service that interfaces with your practice management system, reducing multiple entries of patient data and populating patient records.

Provide better care through ePrescribing.

Select an ePrescription service that gives you access to the patient’s FULL prescription history at your fingertips.

Access all prescriptions, including controlled substances, dispensed at 42 journal | July/August 2020

any U.S. pharmacy over the past twelve months.

Access drug directory information.

A good service provides a built-in, rapid-search Lexicomp drug directory, eliminating additional subscription fees or flipping through pages in the Lexicomp book. In your ePrescription software, use the Lexicomp directory to start typing the drug brand or generic name. It immediately pulls the drug information, including dosing options, contraindications, and discontinued meds.

Take advantage of a cloud-based ePrescribing service.

A cloud-based, HIPAA-compliant ePrescription service gives you full ePrescribe functionality anywhere there’s internet or a hotspot. That kind of flexibility allows you to provide prescription care from home, while traveling, or under unforeseen circumstances.

Improve patient outcomes.

When a patient knows their prescription will be automatically transmitted and most likely ready by the time they get to the pharmacy, they’re more likely to successfully pick up their medication. ePrescribing can be much more than just a new way to comply with prescribing Schedule II-V controlled substances.

Key integrations and automations help to remove human error, verify correct prescriptions and reduce the risk of misuse. As you consider your next step, consider this opportunity to bring multiple functions into one service. You’ll improve workflow and make betterinformed decisions around prescription care.

ABOUT THE AUTHOR: Robert McDermott is President and Chief Executive Officer of iCoreConnect, an award-winning provider of secure cloud-based communications and productivity software for high compliance industries, most notably in dentistry.

During McDermott’s first six months on the job, he met with more than 2,000 dental and medical professionals around the country. Every one of iCoreConnect’s cloud-based services, from our practice management software and HIPAAcompliant email to our ePrescription tool, are designed on the input of those practicing doctors.

Because of McDermott's commitment to the customer and product excellence, iCoreConnect was named one of the United States’ Top 10 Encryption Providers

by Enterprise Security Magazine. iCoreExchange, the company’s HIPAAcompliant email, was named one of Dental Products Report’s Top 50 Products.

Additionally, iCoreConnect was honored as a Top 10 Dental Solution by Healthcare Tech Outlook.

iCoreConnect is an ODA Rewards Partner with expertise in cloud-based technologies to improve and protect your practice. ODA members receive special discount pricing on iCoreRx Empowered ePrescription service. Add the +PMP function to simplify your mandatory prescription check with one-step, real-time access to Oklahoma PMP AWARE. Visit iCoreConnect.com/Oklahoma, or call 888.810.7706.

www.okda.org

43

What Dental Professionals Can Do to Curb Vaping Among Teens By: Chantel Hartman, Cessations Systems Coordinator at the Oklahoma State Department of Health Oklahoma acknowledges the traditional and sacred use of tobacco among American Indian people living in Oklahoma. Unless otherwise stated, any reference to tobacco in this article refers to the use of commercial tobacco.

Information and links to non-Oklahoma State Department of Health (OSDH) organizations are provided solely as a service. Information and links do not constitute an endorsement of any organization by the OSDH, and none should be inferred. The OSDH is not responsible for the content found at non-OSDH links or at links from other agencies or organizations.

The majority of individuals begin using tobacco products by the age of 18. In addition to the lack of product regulation and a national outbreak of lung injury associated with electronic cigarettes, the use of these products among youth and young adults in Oklahoma continues to raise concerns because of the increased risk of nicotine dependence. Electronic cigarettes are noncombustible tobacco products that are often referred to as electronic nicotine delivery systems (ENDS), e-cigarettes, mods, pods, vaping devices, or vape pens. These battery-powered devices are used to inhale, or vape, a solution that usually contains nicotine and flavors. According to the Centers for Disease Control and Prevention, e-cigarettes and vapor devices are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products.1 The evidence for e-cigarettes’ effectiveness as a cessation tool remains inconclusive.

The safest, most evidence-based cessation strategy should include a combination of counseling, nicotine replacement therapy, and/or cessation medications approved by the Food and Drug Administration (FDA).1 As healthcare providers, dentists and dental hygienists play an integral role in addressing health challenges in Oklahoma and have the opportunity to make a significant impact on the health of future generations by educating young patients, parents, and their communities about 44 journal | July/August 2020

the dangers of e-cigarette use and early nicotine exposure. To assist with those efforts, the Oklahoma State Department of Health’s (OSDH) Center from Chronic Disease Prevention and Health Promotion created the Tobacco Prevention & Youth Engagement Resource Guide. This free digital resource guide houses tobacco and vape prevention, cessation, and training resources from national and local experts in one convenient space.

Examples of these resources include the National Cancer Institute’s Smokefree. gov Initiative, the Truth Initiative’s® This is Quitting E-cigarette Quit Program, and the FDA’s Exchange Lab. The full resource guide can be found on the OSDH’s Health Promotion webpage under Resources & Trainings. A few examples of how you can educate patients and staff on the importance of remaining tobacco-free and vape-free include:

• Re-post tobacco-free and vape-free messages from the CDC and FDA social media pages on your practice’s social media accounts.

For more information about the dangers of youth access to tobacco products, youth engagement, or the Tobacco Prevention & Youth Engagement Resource Guide, please contact the OSDH’s Center for Chronic Disease Prevention and Health Promotion at OSDH.TobaccoPrevention@health. ok.gov. The OSDH’s Center from Chronic Disease Prevention and Health Promotion provides assistance and consultation regarding wellness to any Oklahoma business, organization, association, or coalition. We can provide the following services: • Assistance with environmental assessments, policy development and implementation;

• Adopt a tobacco-free/vape-free policy for your practice.

• Assistance in implementing a Helpline referral system;

• Treat tobacco use using the 5 A’s (a billable procedure through OK Medicaid) and directly refer patients to the Oklahoma Tobacco Helpline for free counseling and nicotine replacement therapy.

• Sample policies related to physical activity, nutrition, tobacco, and health screening; • Resources on how to begin or enhance a wellness program, including the adoption of policies related to physical activity, nutrition, and tobacco;

• Apply for the Certified Healthy Oklahoma Business Program to show your commitment to providing a healthy environment for employees and patients.

• Content expertise and information regarding best practices;

• Update patient intake forms to ask about tobacco and vaping use in plain language.

• Information and technical assistance – trends, data, and best practices;

• Request a virtual lunch and learn e-cigarette training from the State Health Department to build staff confidence on terminology and product identification.

• Data related to chronic conditions, physical activity, nutrition, and tobacco; and

• Play the United States Surgeon General’s 30-second video on the dangers of e-cigarettes and vaping in your practice’s waiting room.

• Training, materials, and tool kits;

• Best practices being implemented and/or suggested by the State of Oklahoma.

SMOKEFREE TEEN

Target audience: Anyone at least 13 years old Smokefree Teen is part of the National Cancer Institute’s Smokefree.gov Initiative.3 The goal of Smokefree Teen is to reduce the number of youth who use tobacco by providing information grounded in scientific evidence and offering free tools that meet teens where they are—on their mobile phones. The Smokefree.gov Initiative’s text messaging program can help teens quit vaping by helping them set a date to quit vaping, make a plan that works, and manage withdrawal symptoms. The quitSTART app helps teens become smoke-free by providing helpful strategies for tackling cravings, bad moods, and other situations. The Smokefree.gov Initiative also provides specific resources for Spanish-speaking populations, veterans, women, and individuals over 60 years old.

TRUTH INITIATIVE® THIS IS QUITTING E-CIGARETTE QUIT PROGRAM

Target audience: Teens, Young Adults, and Parents

This is Quitting2,4 is a free mobile program from Truth Initiative® designed to help young people quit vaping. The first-of-its-kind text-messaging program incorporates messages from other young people who have attempted to, or successfully, quit e-cigarettes.

The program’s messages show the real side of quitting, both the good and the bad, to help young people feel motivated, inspired and supported throughout their quitting process. They also send young people evidence-based tips and strategies to quit and stay quit.

This is Quitting is tailored based on age (within 13 to 24 years old) and product usage to give teens and young adults appropriate recommendations about quitting. Teens and young adults can join for free by texting “DITCHJUUL” to 88709. Adults looking to help young people quit vaping can text "QUIT" to (202) 899-7550 or download free promotional materials for their communities.

FOOD AND DRUG ADMINISTRATION EXCHANGE LAB

Target audience: Health Officials, Nonprofit Organizations, and Schools

The Exchange Lab5 is run by the FDA Center for Tobacco Products and provides free print materials and web content aimed at communicating the dangers of tobacco use. The FDA will mail print materials, including posters and flyers, directly to you at no charge. You can also download images to save and post on Facebook and Instagram or place web content from FDA's Center for Tobacco Products on your website. When the FDA updates this syndicated web content, the updates automatically appear on your site, ensuring that all content stays up to date.

REFERENCES: 1. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes. html#:~:text=E%2Dcigarettes%20are%20not%20safe,in%20helping%20adults%20quit%20smoking.

2. Truth Initiative. Retrieved from https://truthinitiative.org/sites/default/files/media/files/2020/02/Truth_E-Cigarette_FactSheet%202019_Update_010920.pdf 3. National Cancer Institute-Smokefree.gov Initiative. Retrieved from https://teen.smokefree.gov/about-teen 4. Truth Initiative. Retrieved from https://truthinitiative.org/thisisquitting 5. Food and Drug Administration. Retrieved from https://digitalmedia.hhs.gov/tobacco/

ABOUT THE AUTHOR: Chantel Hartman currently serves as Cessations Systems Coordinator at the Oklahoma State Department of Health.

Her duties include the management and oversight of collaborative, population-based cessation assessments and assistance programs for adults and youth in Oklahoma. Hartman received her Master of Public Administration degree with a concentration in Public Health Administration from Troy University and a Bachelor of Science in Biology from Auburn University Montgomery. In addition to completing the Centers for Disease Control and Prevention's Office on Smoking and Health Leadership and Sustainability School, Hartman is a Millennial Policy Initiative Commission on Healthcare Senior Fellow and abstract reviewer for Alcohol, Tobacco and Other Drugs section of the American Public Health Association. www.okda.org

45

Oklahoma Scores a “D” on Its Oral Health Report Card INAUGURAL REPORT CARD REVEALS ORAL HEALTH IMPROVEMENT NEEDED IN OKLAHOMA The Oklahoma Oral Health Coalition (OOHC) has released an oral health report card for the State of Oklahoma. The report card provides a framework for discussion on the challenges various populations face in accessing dental care. The report reveals that, when compared to the nation’s performance on 13 key oral health indicators, Oklahoma often scores an F and has an overall score of D. The 13 indicators reflect the most recent data available in each category. Key findings about children include: • 16 percent of children ages 1-2 have received a preventive dental care visit • 49 percent of children ages 1-20 have received a preventive dental care visit • 66 percent of third graders have treated or untreated tooth decay • 25 percent of third graders have dental sealants on permanent molars Key findings about adults include: • 58 percent of ages 18-64 visited the dentist in the last year • 43 percent of ages 65+ have lost six or more teeth due to tooth decay or gum disease • 35 percent of pregnant women had their teeth cleaned during pregnancy “In Oklahoma in particular, there is this reality that oral health and oral health care are not seen as an important part of overall health and health care,” said Marsha W. Beatty, chair of the Oklahoma Oral Health Coalition and assistant professor of research at the University of Oklahoma College of Dentistry.

“This report card illustrates the gravity of oral health neglect in our state,” said Terrisa Singleton, secretary of the Oklahoma Oral Health Coalition and director of the Delta Dental of Oklahoma Foundation. “It affirms the need to continue educating Oklahomans about the importance of receiving preventive dental care and to continue working on ways to improve their access to dental care."

View the complete report card on pages 47 & 48.

J O I N T H E C O N V E R S AT I O N OOHC has scheduled a follow-up FREE forum for Friday, Aug. 21, to provide dental, medical and public health professionals, oral health safety net organizations, policymakers, funders and others the opportunity to further explore the oral health challenges in Oklahoma, the impact of those challenges and potential solutions. Pre-registration is required. To learn more and pre-register visit oohc.org.

46 journal | July/August 2020

Oklahoma Oral Health Report Card 2020 State Score:

D

When compared to the nation’s performance on 13 key oral health indicators, Oklahoma scores a D. The Oklahoma Oral Health Coalition is a collaboration of organizations and individuals committed to impacting the oral health of Oklahomans.

We created this report card to illustrate the gravity of the oral health problem in our state. Working together, we can improve these grades and the oral wellness of Oklahomans.

INDICATOR

GRADE

CHILDREN: ENROLLED IN MEDICAID 1

16% of ages 1-2 received a preventive dental care visit

F

2

49% of ages 3-5 received a preventive dental care visit

C

3

49% of ages 1-20 received a preventive dental care visit

C

4

10% of ages 6-14 received dental sealants on permanent molars

F

CHILDREN: GENERAL POPULATION 5

72% of ages 1-17 received one or more dental visits last year

D

6

66% of third graders have caries experience (treated or untreated tooth decay)

F

7

25% of third graders have dental sealants on permanent molars

F

ADULTS 8

58% of ages 18-64 visited the dentist in the last year

D

9

43% of ages 65+ have lost six or more teeth due to tooth decay or gum disease

D

10

21% of ages 65+ have lost all of their natural teeth due to tooth decay or gum disease

F

11

35% of pregnant women had their teeth cleaned during pregnancy

F

GENERAL POPULATION 12

70% of Oklahomans have access to fluoridated water (natural or adjusted)

C

13

40% of needs were met in Dental Health Provider Shortage Areas

A

For a PDF containing sources and details, go to oohc.org

Development and Underwriting by

www.okda.org

47

Oklahoma Oral Health Report Card 2020 Comparison Chart CHILDREN: ENROLLED IN MEDICAID

DESIRED TREND

OK %

US %

% DIFFERENCE

POINTS

GRADE

1

% of ages 1-2 received a preventive dental care visit

15.9

26.2

48.9 worse

0

F

2

% of ages 3-5 received a preventive dental care visit

48.6

51.8

6.4 worse

2

C

3

% of ages 1-20 received a preventive dental care visit

48.9

48.1

1.6 better

2

C

4

% of ages 6-14 received dental sealants on permanent molars

10.1

15.4

41.6 worse

0

F

CHILDREN: GENERAL POPULATION 5

% of ages 1-17 received one or more dental visits last year

72.4

80.2

10.2 worse

1

D

6

% of third graders have caries experience (treated or untreated tooth decay)

66.0

51.6

24.5 worse

0

F

7

% of third graders have dental sealants on permanent molars

25.2

38.2

41.0 worse

0

F

ADULTS 8

% of ages 18-64 visited the dentist in the last year

58.2

65.7

12.1 worse

1

D

9

% of ages 65+ have lost six or more teeth due to tooth decay or gum disease

43.0

36.0

17.7 worse

1

D

10

% of ages 65+ have lost all of their natural teeth due to tooth decay or gum disease

21.4

14.4

39.1 worse

0

F

11

% of pregnant women had their teeth cleaned during pregnancy

35.3

46.3

27.0 worse

0

F

GENERAL POPULATION 12

% of Oklahomans have access to fluoridated water (natural or adjusted)

69.6

72.8

4.5 worse

2

C

13

% of needs were met in Dental Health Provider Shortage Areas

40.1

29.2

31.5 better

4

A

US COMPARISON

1

D

Method The 13 indicators were chosen based on the following characteristics: •

Recent data are available

•

The indicator shows change over time

•

The indicator increases awareness of the importance of oral health

•

The indicator is meaningful for advocacy and education efforts

•

The data examine demographic characteristics

•

The indicator is tracked at the national level as well as state level

Table 1 Grade A B C D F

Points 4 3 2 1 0

Criteria 20%+ better than US 10.1 - 19.9% better than US 0 - 10% change from US 10.1 - 19.9% worse than US 20%+ worse than US

for comparison The data percentages were turned into number/letter scores by comparing the Oklahoma data to national data. This national comparison grade was determined using the percentage difference between the Oklahoma and US data percentages.

The following percentage difference formula was used to calculate the relative difference between Oklahoma’s percentages and the national percentages:

|V1 – V2| (V1 + V2 )

x 100 = Percent difference of Oklahoma from National

2

V1 = OK percentage V2 = US percentage

Based upon the desired trend of the indicator, the percentage difference is classified as either “better” or “worse” than the national average. The percentage difference was then converted into a numerical point value and letter grade using Table 1. The points for all 13 indicators were averaged to create a total point value for Oklahoma.

That point total was placed on the 4.0 scale (Table 2) to convert the point total to an overall letter grade.

48 journal | July/August 2020

OOHC thanks the Texas Oral Health Coalition for sharing their indicators and methodology.

For a PDF of this document containing sources and comments, go to oohc.org

Table 2 Letter Grade 4.0 Scale A 4.0 A3.7 B+ 3.3 B 3.0 B2.7 C+ 2.3 C 2.0 C1.7 D+ 1.3 D 1.0 D0.7 F 0.0

CLASSIFIEDS Looking to fill an open position in your office, need to sell dental equipment or a practice? Check out the latest listings below and visit okda.org/classifieds for additional listings.

JOB OPENING Associate/Partner Group Practice NE Oklahoma Smiles is a family practice located in Miami, OK. Dr. Jamie Branham Williams opened the office in 2011 and we have been growing ever since. We are seeking another dentist to work 3-5 days/week. Opportunity is for an associate or partner. We are fully digital with electronic charting in Eaglesoft, A-dec 500 operatories, a Prexion Excelsior CBCT, and much more. Miami is located within 30 minutes of Joplin, MO and a little over an hour from the Tulsa area.

Contact: Kirk Williams | 918-541-5888 | kirk@smilesmiami.com

EQUIPMENT INTRAORAL X-RAY SENSOR REPAIR/SALES: We repair broken sensors. Save thousands in replacement costs. Specializing in Kodak/Carestream, major brands. We buy/sell sensors. American SensorTech 919-229-0483 www.repairsensor.com

Place a Classified Ad Placing an ad with the ODA allows you to target your ad to a specific audience. Unlike other classified ad sources (local newspaper, other online classified sites, etc.), a listing with the ODA gives you exposure to the people who would be most interested in your ad. The online version of the ODA Journal contains active hyperlinks within the advertisement, ensuring you get maximum exposure for your ad.

SUBMIT A LISTING Submitting a classified ad is easy with our online form.

Find the form and more information at www.okda.org/classifieds.

PRICING ODA Members Online - Free ODA Journal - $40 for first 50 words (additional words $0.15 each)

Non-ODA Members

Visit: www.okda.org/classifieds

Online or ODA Journal - $83 (>50 words) (additional words $0.32 each) Bundle (online & Journal) $149 (>50 words) (additional words $0.32 each)

QUESTIONS? Email: advertising@okda.org

Call: 800.876.8890

www.okda.org

49

FINAL THOUGHTS

WORDS OF WISDOM FROM DR. RACHEL STANDLEE, TULSA 1. Who is your Mentor? (Professional and/or Personal) I have had several professional mentors throughout my dental career, however, the one from dental school to current is Dr. Jim Kessler. He is a man of integrity and honesty. He is an "encyclopedia of dentistry" and always provides proper guidance and direction for challenging cases.

Dr. Standlee's husband,Shawn, Dr. Standlee and their son, Quinton.

2. What “words of wisdom” would you share with a Dentist one year out of school?

• Have a biblical presence in your life which helps to guide your choices and actions.

• Surround yourself with others who make you a better person.

• Self-sacrificially make choices, putting others first, and you will see that it ultimately returns to you in some form or fashion over time.

Dr. Standlee with her awesome staff.

3. Do you think you are wiser now than you were when you were younger?

As I age, I have had more experiences--both positive and negative-- so I do feel more wise.

Wisdom is a result of experiences in life. I am excited for the opportunity to have more life experiences as I age and gain more wisdom.

4. What’s the secret to happiness? The secret to happiness, in my opinion, is being happy within yourself! We are our own best cheerleader and worst critic, all in the same.

Happiness is a choice and every day we are blessed with the opportunity of choice. We get to choose how we respond to the triumphs and challenges that that specific day brings.

5. When was the last time you learned something new? Every day I have the opportunity to learn something new. In my personal and professional life...every day is a new day with new things to learn...professionally, every tooth is different even if the procedure is the same...personally, every choice results in learning something from the choice.

50 journal | July/August 2020

www.okda.org

Unite the Healthiverse

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Delta Dental of Oklahoma has completed its launch of Health through Oral WellnessÂŽ (HOWÂŽ).

Available Now!

Register your practice location(s)* at DeltaDentalOK.org/HOWReg

52 journal | July/August 2020

Effective July 1, more than 8,500 of our fully-insured groups have access to HOW enhanced benefits.

Our members at higher risk for developing caries and/or periodontal disease could qualify to receive additional preventive benefits, based on the results of the HOW approved assessment performed in a dentist office.

Please contact our Provider Relations team for assistance at 405-607-2137 (OKC Metro), 800-522-0188, Ext. 137 (Toll Free) or via email at PR@DeltaDentalOK.org.